|Why does my child have a white pupil (leukocoria)?|
A white pupil (leukocoria) in a child or newborn baby is never normal and is very concerning. One should promptly take their child to be examined by an eye doctor. There are multiple conditions that can cause a white pupil. All of these conditions require specialty eye care and treatment.
The most common condition to cause a white pupil in a child is a congenital cataract. Cataracts are white opacities in the intraocular lens. There are numerous causes for cataracts in children. These include medications, viral infections, ocular diseases, genetic disease, metabolic disorders and inflammatory conditions. Most pediatric cataracts are congenital or cause by trauma. An eye doctor can easily diagnose a cataract. An ophthalmologist may perform cataract surgery to remove the cataract if it is dense.
If there is a significant cataract and it is not removed the child will form amblyopia in that eye. Amblyopia is the permanent decrease of vision due to the visual pathway not developing as a child. In order for the visual pathway to develop fully there needs to be a clear image on the retina during development. A cataract will create a blurry image.
Retinoblastoma is an intraocular tumor that occurs during childhood. This tumor is developed from a mutation in the genetic code. Typically, it is diagnosed between 12-24 months of age. Treatment depends on the stage of the tumor and systemic findings. Treatment can include lasers, radiation plaque, beam radiation, chemotherapy or surgery.
Retinopathy of Prematurity
Retinopathy of prematurity (ROP) occurs in low birth weight infants. Infants that are born premature, less than 36 weeks of age, birth weight less than 2000 grams, or oxygen therapy are at higher risk of developing ROP. ROP causes new blood vessels to grow in the retina. These new blood vessels are abnormal and can lead to scaring and fibrosis. Fibrosis traction can cause the retina to detach. This can lead to the decrease of vision or blindness.
A retinal detachment is what happens when the retina separates inside the eye. When the retina detaches one will experience flashes of light and loss of vision. Retinal detachments can often be repaired by laser surgery, cryotherapy, and/or scleral buckle.
Toxocariasis is an eye inflammatory condition caused by an intestinal roundworm found in soil. This intestinal roundworm is a nematode often found in dogs. Children are exposed to this roundworm by eating dirt. Toxocariasis can often cause severe retinal scaring, retinal detachments, and permanent poor vision. Treatment options are limited.
Some other less common causes for leukocoria are familial exudative vitreoretinopathy, coats’ disease, retinal astrocytoma, norrie’s Disease, persistent hyperplastic vitreous and incontinentia pigmenti.
If your child or someone you know has a child with a white pupil they should be under the care of an ophthalmologist as soon as possible.
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