Dr Adil Ramzan White pupillary reflex is the whitish appearance of pupil. This condition is also known as leukocoria. It can occur in a number of conditions. Following are the causes of white pupillary reflex in early life and these causes must be included in the differential diagnosis.
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Dr Adil Ramzan White pupillary reflex is the whitish appearance of pupil. This condition is also known as leukocoria. It can occur in a number of conditions. Following are the causes of white pupillary reflex in early life and these causes must be included in the differential diagnosis. Congenital Cataract A congenital cataract is the congenital opacity of the lens of the eye. When light is thrown into the eye it gives white pupillary reflex.
Retinoblastoma It is a congenital tumour of retina. It is a life-threatening malignant condition and it usually occurs within the first three years of life. It is a disease of the retina. It usually occurs in premature infants who are kept in incubators under high pressure of oxygen.
High oxygen has been identified as a case of retrolental fibroplasia. It is a fibrovascular mass present behind the lens. It impairs the vision and it gives white pupillary reflex on examination.
In this condition, retinal vessels are not well formed and their continuous leakage results in exudation and retinal detachment. It also gives white pupillary reflex on examination. Endophthalmitis It is the inflammation of intraocular cavities. It is a dangerous condition and if remains untreated, invariably lead to blindness. It also causes white pupillary reflex. Toxocarial Granuloma It is an inflammatory condition that occurs due to the presence of larvae in the vitreous chamber of the eye.
On examination, it too gives white pupillary reflex. How to make a diagnosis. The intraocular examination is needed to make a clear diagnosis. Fundoscopy and slit lamp examination should be done.
Vitreous hemorrhage can be seen occasionally with very advanced tumors. As a general rule, retinal traction or cataracts are not seen with untreated retinoblastoma. Anterior segment involvement by retinoblastoma can cause pseudohypopyon or hyphema Fig. In advanced cases, rubeosis iridis, neovascular glaucoma, buphthalmos, and even orbital cellulitis and proptosis may be encountered Fig. External photograph demonstrating the appearance of diffuse retinoblastoma a , B-scan ultrasonography revealed irregularly thickened retinal detachment with vitreous cells b. Typical features of retinoblastoma including intraocular mass and intraocular calcification were not present. Magnetic resonance imaging confirmed enhancing thickened retina c.
Causes of White Pupillary Reflex Differential Diagnosis Leukocoria
Posted on by Pediatric Education Patient Presentation A previously full-term, 2-month-old male came to clinic for his health supervision visit. His parents reported that he was doing well including no concerns about his vision or hearing. On his visual examination he showed some turning of his head with the cover test when his right eye was occluded. The anterior chamber and lens appeared normal. The right eye showed a normal red reflex and normal retinal vessels and part of the optic disk.
Differential Diagnosis of Leukocoria
Leukocoria is present in over half of all infants presenting with retinoblastoma. Other conditions may also be associated with leukocoria as a presenting symptom, including: congenital malformations e. Retinoblastoma is also the second most prevalent intraocular malignant tumor after uveal melanoma 5. Retinoblastoma is composed of retinoblasts basophilic cells with hyperchromatic nuclei and scanty cytoplasm. Mostly retinoblastomas are undifferentiated, but different degrees of differentiation are present owing to the formation of structures known as rosettes. The tumor can be endophytic in vitreous and seeding of tumor cells throughout the eye, or it can be exophytic in subretinal space , or it can demonstrate a mixed presentation.
What is the Differential Diagnosis of Leukocoria?