Leukocoria: Symptoms, Causes, Treatment

What are the symptoms of leukocoria?

Leukocoria, also known as “white pupil,” is a condition in which the pupil of the eye appears white instead of the normal black. This symptom can be observed in photographs taken with a flash or during a physical examination. Leukocoria is often a sign of an underlying eye condition or disease. The primary symptom of leukocoria is the white reflection from the pupil, but depending on the underlying cause, other associated symptoms may include:

1. Visible White Reflection in the Pupil: This is the hallmark symptom of leukocoria and may be noticeable in photographs or during an eye examination.
2. Strabismus (Misalignment of the Eyes): One or both eyes may appear to be misaligned or turned in different directions, often referred to as “crossed eyes.”
3. Poor Vision: The affected eye may have reduced visual acuity or blurred vision.
4. Nystagmus: Involuntary, rapid eye movements may be present.
5. Redness or Irritation: The eye may appear red or irritated.
6. Difference in Pupil Size (Anisocoria): The pupils may be of unequal sizes, which can sometimes be associated with the underlying condition causing leukocoria.
7. Absence of Red Reflex: During an eye examination, the normal red reflex seen when light is shone into the eye may be absent.
8. Glaucoma Symptoms: If associated with conditions like congenital glaucoma, symptoms might include excessive tearing, sensitivity to light, and eye pain.

Leukocoria can be a sign of several serious eye conditions, including:

• Retinoblastoma: A malignant tumor of the retina, most common in young children.
• Congenital Cataract: Clouding of the eye’s lens present at birth.
• Coats’ Disease: An abnormal development of blood vessels behind the retina.
• Persistent Fetal Vasculature (PFV): A condition where the blood vessels in the eye fail to regress as they should after birth.
• Retinopathy of Prematurity (ROP): A disease that affects premature infants, leading to abnormal retinal blood vessel development.
• Toxocariasis: An infection caused by the Toxocara parasite, which can lead to eye inflammation and vision problems.

If leukocoria is observed, it is essential to seek immediate medical attention from an ophthalmologist for a thorough examination and prompt diagnosis of the underlying cause. Early detection and treatment are crucial for preserving vision and addressing potentially life-threatening conditions such as retinoblastoma.

How is the diagnosis of leukocoria made?

The diagnosis of leukocoria is typically made through a combination of:

1. Eye examination: A comprehensive eye examination by an ophthalmologist or optometrist to evaluate the appearance of the pupil and the overall health of the eye.
2. Slit-lamp biomicroscopy: A slit-lamp biomicroscope is used to examine the eye and diagnose conditions such as cataracts, uveitis, and retinal detachments.
3. Fundoscopy: A fundoscope is used to examine the retina and optic nerve.
4. Imaging studies: Imaging studies such as ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) may be used to further evaluate the eye and diagnose conditions such as retinal tumors or optic nerve disorders.
5. Dilated eye exam: A dilated eye exam is performed to evaluate the retina and optic nerve.
6. Visual acuity test: A visual acuity test is performed to assess the sharpness of vision.
7. Visual field test: A visual field test is performed to assess peripheral vision.

The diagnosis of leukocoria is often made by an ophthalmologist or optometrist, but in some cases, a pediatrician or other healthcare provider may also be involved in the diagnosis.

It’s important to note that leukocoria can be a symptom of a more serious underlying condition, so it’s essential to have it evaluated by a qualified healthcare professional as soon as possible if it’s detected.

What are the possible treatments for leukocoria?

The treatment for leukocoria depends on the underlying cause of the condition. Some possible treatments for leukocoria include:

1. Surgery: Surgery may be necessary to remove a tumor or other abnormal growth in the eye.
2. Medications: Medications such as antiviral or antibacterial drugs may be prescribed to treat infections that are causing leukocoria.
3. Laser therapy: Laser therapy may be used to treat certain conditions that cause leukocoria, such as retinal detachments.
4. Cryotherapy: Cryotherapy is a type of treatment that uses extreme cold temperatures to freeze and destroy abnormal tissue.
5. Photocoagulation: Photocoagulation is a type of treatment that uses light to destroy abnormal blood vessels in the eye.
6. Intravitreal injections: Intravitreal injections are a type of treatment that involves injecting medications into the vitreous humor of the eye to treat conditions such as macular edema.
7. Oral medications: Oral medications may be prescribed to treat underlying conditions such as diabetes or hypertension that can contribute to leukocoria.
8. Eye drops or ointments: Eye drops or ointments may be prescribed to treat dry eye or other conditions that can cause leukocoria.
9. Surgical removal of the eye: In some cases, surgery may be necessary to remove the affected eye if it is no longer functional or if it is causing significant discomfort or vision loss.

It’s important to note that the specific treatment for leukocoria will depend on the underlying cause and severity of the condition, and will be determined by an ophthalmologist or other eye care professional.