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JAMA Clinical Challenge

A Child With a White Pupil

Image of Patient at presentation with leukocoria (abnormal white pupillary reflection)

Najim Lahrouchi, MD
Machteld I. Bosscha, MD
Annette C. Moll, MD, PhD

A healthy 4-year-old girl presents to the ophthalmologist for evaluation of a white pupil (Figure). The parents had noted a white pupillary reflection in the left eye for the past 2 months. On ophthalmologic examination, the visual acuity of the right eye was 6/7.5 (equivalent to 20/25) and the left eye did not follow an object. The remainder of the physical examination was unremarkable. There was no family history of childhood cancers, and the patient did not have any other pertinent or contributory medical history.

See the full article for an explanation and discussion.

Author Affiliations: Drs Lahrouchi (najim_lahrouchi@hotmail.com), Bosscha, and Moll are affiliated with the Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.