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Approach to the child with leukocoria

Paul L Kaufman, MD
Jonathan Kim, MD
Jesse L Berry, MD
Section Editor
Evelyn A Paysse, MD
Deputy Editor
Carrie Armsby, MD, MPH


The term leukocoria means "white pupil" (from the Greek "leukos" meaning white and "kore" meaning pupil) and is the name given to the clinical finding of a white pupillary reflex (picture 1). Leukocoria can be caused by abnormalities in the lens (eg, cataract), vitreous (eg, hemorrhage), or retina (eg, retinoblastoma) (table 1) [1,2]. It can be the initial manifestation of a wide spectrum of intraocular and systemic disease processes [3-7]. The differential diagnosis can be narrowed through a complete clinical and family history and a thorough ophthalmic examination.

Although transient leukocoria is occasionally caused by the reflection of a normal optic disc (called pseudoleukocoria), all children with newly discovered leukocoria should be referred urgently (ie, within one week) to an ophthalmologist to exclude retinoblastoma and other life- or sight-threatening conditions [8]. (See 'Referral' below.)

The evaluation and management of the child with leukocoria and a brief discussion of the common causes of leukocoria in children are presented here. Retinoblastoma is discussed separately. (See "Retinoblastoma: Clinical presentation, evaluation, and diagnosis".)


The common causes of leukocoria in children include:

Retinoblastoma (18 to 62 percent of cases) [9-11]


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Literature review current through: Sep 2016. | This topic last updated: Feb 12, 2015.
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