In a 2-month-old infant with leukocoria, which diagnosis is most commonly associated?

In a 2-month-old infant with leukocoria, which diagnosis is most commonly associated?

• A. Neuroblastoma
• B. Retinoblastoma
• C. Retrolental fibroplasia
• D. Congenital cataracts

Answer: (B)

Leukocoria, a white reflection from the pupil, is a red flag in an infant. The presentation most strongly points to retinoblastoma, an intraocular tumor that typically appears in early childhood and often first shows up as a white pupillary reflex. Because it is malignant and can threaten vision and life if not treated early, recognizing this association is crucial and prompts urgent ophthalmology evaluation and imaging. Other causes can produce leukocoria, but they don’t fit as naturally in a 2-month-old: congenital cataracts cause a lens opacity visible on exam; retinopathy of prematurity occurs in premature infants with a history of oxygen therapy and presents with retinal vascular abnormalities; neuroblastoma can involve the orbit and cause proptosis, but leukocoria is less characteristic as the primary sign in such young infants.

Leukocoria, a white reflection from the pupil, is a red flag in an infant. The presentation most strongly points to retinoblastoma, an intraocular tumor that typically appears in early childhood and often first shows up as a white pupillary reflex. Because it is malignant and can threaten vision and life if not treated early, recognizing this association is crucial and prompts urgent ophthalmology evaluation and imaging.

Other causes can produce leukocoria, but they don’t fit as naturally in a 2-month-old: congenital cataracts cause a lens opacity visible on exam; retinopathy of prematurity occurs in premature infants with a history of oxygen therapy and presents with retinal vascular abnormalities; neuroblastoma can involve the orbit and cause proptosis, but leukocoria is less characteristic as the primary sign in such young infants.