Leukocoria: Differential Diagnosis
Pediatric Ophthalmology: Ocular Emergency
1. Major Differential Diagnoses
| Condition | Key NEET Clinical Feature |
|---|---|
| Retinoblastoma | Most important/life-threatening; calcification is often visible on CT. |
| Congenital Cataract | The most common cause of leukocoria requires urgent surgery. |
| Retinopathy of Prematurity (ROP) | History of prematurity, oxygen therapy; potential for retinal detachment. |
| Toxocariasis | History of exposure to puppies/soil; unilateral inflammation. |
| Coats’ Disease | Idiopathic retinal telangiectasia with exudation; more common in males. |
2. High-Yield NEET Pearls
- Retinoblastoma: The “classic” presentation. Bilateral cases are usually hereditary (germline RB1 mutation); unilateral cases are typically sporadic.
- Management: Leukocoria in a child is a “red flag” requiring immediate referral to an ophthalmologist for dilated fundus examination. Never delay assessment.
- Imaging: CT scan is superior to MRI for detecting the pathognomonic calcifications in retinoblastoma.
- Comparison: Differentiate from Phthisis Bulbi (small, disorganized eye), which can also present with a white pupil following trauma or severe inflammation.