A 19-day-old boy was referred for unilateral buphthalmos (Fig A) with intraocular pressure (IOP) measured at 28 mmHg with rebound tonometer. Examination under anesthesia showed keratic precipitates, iris granulomata, and pupillary seclusion (Fig B). Oral josamycin, topical steroids, and β-blockers allowed for the normalization of IOP within a day, and for the resolution of inflammation within 2 weeks. Microbial culture of a lens sample taken during cataract surgery, which was performed 4 weeks after first examination (Fig C) revealed some colonies of Spiroplasma ixodetis on agar medium (A7) (Fig D, magnification ×40). This rare uveitis has to be distinguished from congenital glaucoma, and must be medically treated before performing lens extraction (Magnified version of Fig A-D is available online at www.aaojournal.org).