Leukokoria – The White Pupil

· Leukokoria is seen in 50-60% of the patients with retinoblastoma
· Retinoblastoma is the most common intraocular malignancy in children, usually detected in the primary care clinic (which the ED often is now).
· Median age of diagnosis: unilateral = 24 months; bilateral = 12 months
· Metastatic disease: direct extension to CNS, hematogenous to bones, lung, and brain
· When detected early, it is one of the most curable childhood cancers!
· Untreated, almost all will die within 2 years!!
· Morale of the story: it is easy to flash a ophthalmoscope light in a child’s eyes to ensure that there is a normal red reflex… do it… if it is not normal, you just had a significant impact in the child’s life!
· Refer anyone without a normal red reflex to an ophthalmologist within 1 week.
WG Wilson, JR Serwint. Retinoblastoma. Pediatrics in Review. 2007;28:37-38

Melamud A, Palekar R, Singh A. Retinoblastoma. Am Fam Physician. 2006 Mar 15;73(6):1039-44.


Sean M. Fox
Sean M. Fox
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