A child with leukocoria.

Leukocoria, meaning "white pupil," describes the clinical finding of a white pupillary reflex on examination. It may be discovered through an asymmetric red reflex using direct ophthalmoscopy, or it may be seen incidentally on flash photography. It results from an abnormality of the eyeball that interferes with the normal reflective process. We report a case of a 3-year-old boy who presents with leukocoria found to be caused by a retinoblastoma and discuss the differential diagnosis of this uncommon presentation to the pediatric emergency department.