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A 2-year-old African American boy with no significant medical or ocular history was referred to the pediatric ophthalmology clinic after his pediatrician noted leukocoria in his left eye during a routine well-child visit. His visual acuity was 20/30 OD but the child was unable to read the distance chart with his left eye. His vision was central, steady, and unmaintained in the left eye. Worth 4-dot testing showed evidence of suppression in the left eye. There was a relative afferent pupillary defect in the left eye. Intraocular pressure was soft by palpation in both eyes. The eyelids, conjunctiva, sclera, cornea, anterior chamber, iris, and lens were unremarkable in both eyes. Fundus examination of the right eye was normal. The fundus examination of the left eye revealed the findings shown in Figure 1.
Ali MH, Chau FY, Abbasian J. Leukocoria and Decreased Vision Detected During a Routine Pediatric Screening Eye Examination. JAMA Ophthalmol. 2016;134(9):1069-1070. doi:10.1001/jamaophthalmol.2016.1687