INTRODUCTION: Leukocoria or the white eye reflex is an abnormal pupillary light reflection on ocular examination and is usually indicative of serious intraocular pathology. It is most often seen in children. Immediate diagnosis and management are mandatory as most conditions are vision threatening, and some like retinoblastoma life threatening. It is important to identify underlying pathologies early, especially conditions such as retinoblastoma with immediate referral to a pediatric ophthalmologist. An interdisciplinary liaison with a pediatric radiologist, retina specialist, and ocular oncologist will help in the management of eyes with leukocoria in an appropriate manner. Imaging also plays a critical role in assessing treatment response. In this educational exhibit, we will highlight key cross-sectional imaging findings of ocular abnormalities associated with leukocoria that provide valuable clues in diagnosing the important pathologies in the pediatric population. These findings may include calcific masses, microphthalmia, vascular abnormalities, hemorrhage and enhancement patterns, all which aid in narrowing down the differential diagnosis of leukocoria. Conclusion: The diagnosis of intra-ocular pathologies commonly resulting in pediatric leukocoria is a complex task that often necessitates a multidisciplinary approach, complemented by multimodality imaging and often genetic analysis. Cross-sectional imaging proves to be a valuable tool for refining the list of potential diagnoses based on structural abnormalities and guiding clinicians towards specific confirmatory tests. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Rao Jhanavi, Thakor Dipakkumar, Schroeder Jason

Keywords: Orbit, CT, Magnetic Resonance Imaging MRI