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