A review for medical students.

1. LEUKOCORIA
By: Qurat-ul-ain
Ophthalmic Medical
Technologist/ MBA Health &
Hospital management

2. Retinoblastoma
• A malignant tumor of the retina that
appears as a white, nodular mass that
breaks through the internal limiting
membrane into the vitreous as a yellowish
sub-retinal mass lesion after underlying a
serous retinal detachment or as a lesion
simulating uveitis.
• Iris neovascularization is common.
• Cataract is uncommon and the eye is
normal in size
Toxocaiasis
• A nematode infection may appear as a
localized, white, elevated granuloma in the
retina or as a diffuse endophthalmitis.
• Localized inflammation of ocular structures,
vitreous traction bands, traction retinal
detachment and cataract.

3. Coats Disease
• A retinal vascular abnormality resulting in
small multifocal out-pouchings of the
retinal vessels.
• May develop secondary to bullous retinal
detachment associated with sub-retinal
fluid.
PHPV
• A developmental ocular abnormality
consisting of varied degree of glial and
vascular proliferation in the vitreous cavity.
• Membrane behind the lens, place inward
traction on the ciliary processes.
• The membrane and lens may rotate
anteriorly, shallowing the anterior chamber
and resulting in secondary glaucoma.

4. Pediatric cataract
• Opacity of the lens present at birth.
• May be unilateral and bilateral
• May be associated with systemic disorder.
Retinal astrocytoma
• Slightly elevated, yellowish white retinal
mass that may be calcified and is often
associated with tuberous sclerosis and
rarely neurofibromatosis.
• May occur in optic nerve head (giant
drusen)

5. ROP
• Predominantly occur in pre-mature
children
• Usually the result of a retinal
detachment.
Others
• Retinal detachment, retinochoroidal,
coloboma, familial exudative
vitreoretinopathy, myelinated nerve
fibers, uveitis, toxoplasmosis, trauma,
CMV retinitis, endophthalmitis, retinal
dysplasia, incontinentia pigmenti, norrie
disease, medulloepithelioma.

6. WORK UP
• History taking
• Complete ocular examination
• B-scan ultrasonography
• Intravenous fluorescein angiogram
• Computed tomographic scan or magnetic resonance imaging (MRI) of the
orbit and brain
• Serum ELISA test for Toxocara
• Systemic evaluation by pediatrician
• Anterior chamber paracentesis
• EUA

7. TREATMENT:
 RETINOBLASTOMA:
• Chemo-reduction, chemotherapy, cryo-therapy, thermotherapy, laser
photocoagulation, plaque radiotherapy.
 Toxocariasis:
• Steroids, vitrectomy, laser photocoagulation
 Coats disease:
• Cryotherapy, surgery required for retinal detachment, anti-VEGF agents if significant
exudates, sub-retinal or intraretinal fluid is present.

8.  PFV:
• Cataract and retrolental glial membrane extraction
• Treat amblyopia
 Pediatric cataract:
• Cataract extraction within days to weeks of discovery, treat amblyopia.
 Retinal astrocytoma: observation
 ROP:
• Ablation of immature, avascular zones of retina. Laser photocoagulation, use of anti-
VEGF intravitreal.

9. RESOURCES:
• The wills eye manual , 7th edition

10. THANK YOU!