Leukocoria is most commonly associated with which condition?

• A. Cataract
• B. Retinoblastoma
• C. Glaucoma
• D. Amblyopia

Answer: (B)

Leukocoria means a white pupillary reflex, an abnormal finding when light is shined into the eye. In children, the most important and classic association is retinoblastoma, a malignant intraocular tumor. The tumor alters the normal red reflex, producing a white appearance in the pupil, which is why this condition must be evaluated promptly.

Cataracts can also cause a white pupil, but retinoblastoma is the condition most strongly linked to leukocoria and is the scenario clinicians worry about first. Glaucoma and amblyopia don’t typically present with a white reflex; glaucoma may show eye pain, redness, or corneal changes, and amblyopia is reduced vision without a white pupil. If leukocoria is observed, urgent eye exam is essential.