Leukocoria

Last updated 20.09.12

Index

Definition

- White pupil reflex

Features

- May be intermittent or gaze dependant

- May be noted during new born examination

- Routine screening for leukocoria

Associated S/S

- Eye exam

- RAPD

- Cataract

- Slit Lamp (Opthalmologist)

- Dilated fundus exam (Opthalmologist)

- Asymetrical red reflex

- Noted in photos (red eye) or fundoscopy

- DDx strabismus

- Prematurity: ROP

- Congenital infections: Rubella (cataracts)..

- Dysmorphisms: syndromes

- Organomegaly (spleen, liver)

- Glucoma, eye pain, fever, vitrous haemorrhage, hyphema, orbital cellulitis, proptosis, stabismus, decreased vision, ocular inflammation: Retinoblastoma

Causes

- Retina

- Retinal dysplasia or detachment

- Retinoblastoma

- Coats disease

- Retinopathy of Prematurity (ROP)

- Lens

- Cataract

- Persistant foetal vasculature

- Vitreous

- Uveitis

- Haemorrhage

- Infection

- Orbital cellulitis

- Toxocariasis

- Colomboma

Ix

- Growth & Development

- +/- EUA

- If paeds & difficult to assess

- +/- Eye US

- If suspect intraocular Ca (retinoblastoma..)

- +/- CT/MRI head + orbits

- If suspect retinoblastoma

Mx

- All paeds need referral to Opthal within 1 week to exclude retinoblastoma via slit lamp

- As per cause

References

Upto Date: Approach to the Child with Leukocoria Sep 2009

Pic: www.eyecancer.com/Patient/Condition.aspx?nID=53&Category=Retinal+Tumors&Condition=Retinoblastoma