Leukocoria, white pupil reflex: What's it, causes, symptoms, diagnostics, treatment, prevention

Pupil – white spots; Leukocoria

What is leukocoria?

Leukocoria is an abnormal white reflex in the pupil area. Leukocoria, also known as "white pupil", may indicate an underlying eye disease or a more serious condition, most often retinoblastoma.

The pupil of the human eye is normally black. The pupil may appear red in flash photographs. Medical professionals call it a "red reflex" and it's normal..

Sometimes the pupil of the eye may appear white, or a normal red reflex may appear white. This is not a normal state, and you need to see an ophthalmologist immediately.

There are many different causes of a white pupil or white reflex.. Other disorders can also cause a white pupil.. If cornea, which is normally transparent, becomes cloudy, she may look like a white pupil. Although the causes of a cloudy or white cornea are different from those of a white pupil or white reflex, these problems also require immediate medical attention.

Cataracts can also lead to, that the pupil will become white.

Causes of leukocoria

Leukocoria can be caused by various reasons., including:

• Retinoblastoma. This is a rare form of eye cancer., which mainly affects young children. Leukocoria is one of the most common symptoms of retinoblastoma..
• Cataracts. Cataracts can cause clouding of the lens of the eye, what causes leukocoria.
• Coats disease. This condition is associated with the abnormal development of blood vessels in the retina., what causes leukocoria.
• Toxocarosis. Infection with Toxocara parasite can lead to inflammation of the eye, causing leukocoria.
• Rubella (kor). Measles can lead to eye inflammation and leukocoria.
• Retinal disinsertion. In some cases, retinal detachment can cause leukocoria.

Symptoms of leukocoria

In addition to a white reflection in the pupil, people with leukocoria may experience other accompanying symptoms., including:

• Reduction of
• Displacement of the eyeball (kosoglazie)
• Redness or inflammation of the eye
• Persistent headaches
• Pain or discomfort in the eyes
• Changing the color of the iris.

When to see a doctor

If you notice leukocoria or any other warning signs in yourself or your child, it is important to see a doctor immediately. Early detection and intervention can be critical for treating underlying conditions, which can cause leukocoria.

Questions, which the doctor may ask

During your visit to the doctor, your doctor may ask you the following questions:

• When did you first notice the white reflection in your pupil?
• Have you noticed any changes in your vision?
• Have you experienced pain or discomfort in your eyes?
• Do you have a family history of eye diseases or conditions?
• Have you or your child experienced a recent eye injury??
• Are there any other symptoms or problems, that you would like to discuss?

Diagnosis of leukocoria

To diagnose the cause of leukocoria, the doctor can perform various tests and examinations, including:

• Comprehensive eye examination
• Testing of visual acuity
• Retinal examination
• US eyes
• Imaging studies, such as computed tomography or magnetic resonance imaging.

Treatment of leukocoria

Treatment for leukocoria depends on the underlying cause. Here are some common treatment approaches:

• Retinoblastoma. If retinoblastoma is the cause of leukocoria, treatment options may include chemotherapy, radiotherapy, cryotherapy, laser therapy or surgical removal of the affected eye. The specific treatment plan will depend on the stage and extent of the cancer..
• Cataracts. Cataracts, causing leukocoria, may require surgical removal of the clouded lens and replacement with an artificial lens.
• Coats disease. Treatment for Coats disease may include laser therapy or cryotherapy, to stop abnormal growth of blood vessels. In more advanced cases, surgery may be required..
• Toxocarosis. Antiparasitic drugs may be prescribed to treat toxocariasis and reduce inflammation in the eyes.
• Rubella (kor). Treating the underlying measles infection can help clear associated eye inflammation and leukocoria..
• Retinal detachment. Surgical intervention, such as pneumatic retinopexy or vitrectomy, may be required to repair retinal detachment and reduce leukocoria.

Treatment of leukocoria at home

Although home treatment cannot eliminate the underlying cause of leukocoria, there are some measures, things you can do to maintain eye health and overall well-being:

• Maintain eye hygiene, gently wiping the eyes with a clean, damp cloth.
• Protect your eyes from bright sunlight, wearing sunglasses with UV protection.
• Eat a balanced diet, rich in fruits, vegetables and omega-3 fatty acids, as these nutrients promote eye health.
• Avoid smoking and limit your alcohol intake, as they can cause vision problems.
• Do regular eye exercises and take breaks when exercising, that strain the eyes, e.g. when reading or using electronic devices for a long time.

Prevention of leukocoria

Although it is not possible to prevent all cases of leukocoria, there are some preventive measures, things you can do to keep your eyes healthy:

• Schedule regular eye exams, especially in young children, to detect any abnormalities at an early stage.
• Protects the eyes from trauma, using appropriate protective equipment, when doing sports or other activities, potentially dangerous to the eyes.
• Encourage healthy habits, such as hand hygiene, to reduce the risk of eye infections.
• Encourage a healthy lifestyle, which includes nutritious food, regular exercise and adequate sleep, as these factors contribute to overall eye health.
• Learn about family history and genetic factors, which may increase the risk of certain eye conditions, and discuss them with your doctor.

Used sources and literature

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.

Olitsky SE, Marsh JD. Abnormalities of the pupil and iris. In: Kliegman RM, St. Geme JW, Bloom NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 640.

Vagge A, Wangtiraumnuay N, Pellegrini M, Scott R, Iester M, Through EC. Evaluation of a free public smartphone application to detect leukocoria in high-risk children aged 1 to 6 years. J Pediatr Ophthalmol Strabismus. 2019;56(4):229-232.PMID: 31322712 pubmed.ncbi.nlm.nih.gov/31322712/.