Leukocoria Differential — RACP Paediatrics MCQ

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EasyInfectious DiseaseLeukocoria DifferentialRACP Paediatrics

A 5-year-old has a painless white pupillary reflex (leukocoria) noticed in a photograph. What is the most important diagnosis to exclude?

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Correct answer: E — Retinoblastoma

Leukocoria (white pupillary reflex) requires urgent ophthalmological assessment to exclude retinoblastoma, the most common intraocular malignancy of childhood. Other causes include cataract, Coat disease, and persistent hyperplastic primary vitreous. Urgent fundoscopy under anaesthesia with MRI orbits is indicated.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Leukocoria