by Wadih Zein, MD

Cataract: can be congenital or acquired, usually causes blurred vision and glare. Persistent hyperplastic primary vitreous: PHPV is a congenital condition caused by failure of the normal regression of the primary vitreous. It is usually associated with unilateral vision loss; Norrie’s disease also involves deafness and mental retardation.

Organized vitreous hemorrhage: vitreous hemorrhage is usually secondary to a neovascular membrane or to a retinal tear. Patients may complain of a red haze, blurred vision, or floaters. As it starts to resolve, color changes to yellow then white and some fibrous sheets may persist. A B-scan is usually diagnostic and vitrectomy is usually required.

Falciform fold: appears as a white fold in the retina that extends to the optic disc. Routine monitoring of the patient is needed.

Retinal detachment: risk factors include trauma and surgery, vitreous detachment, high myopia, retinal breaks or tears, retinal vascular disease, and history of detachment in the other eye. symptoms include flashes of light, floaters, curtain-like decrease in vision. Retinal detachments can be rhegmatogenous, tractional, or exudative. When central they may cause leukocoria.

Retinopathy of prematurity: occurs in premature, low-birth-weight infants maintained on oxygen therapy. Signs include neovascularization, fibrous bands, retinal detachments and vitreous hemorrhage. When advanced leukocoria can be present.

High myopia: progressive bilateral disease with complications such as retianl detachment, staphylomas, and retinal pigment epithelium degeneration.

Coloboma: congenital condition caused by incomplete closure of the the fetal fissure. Degree of visual loss related to area affected (iris, retina, choroid, or optic nerve head)

Medullated nerve fibers: congenital anomaly caused by myelination of the retinal nerve fibers and usually asymptomatic. When large areas are involved it can cause leukocoria.

Chorioretinitis: posterior uveitis, rarely painful but my be associated with blurred vision or scotoma depending on location and extent. Leukocoria can be due to excessive accumulation of debris or to the formation of large chorioretinal scars.

Coat’s disease: typically a unilateral condition found in young boys. It is characterized by retinal telengiectasia and aneurysms that may cause exudative retinal detachments.

Retinoblastoma: most common primary, malignant, intraocular tumor of childhood but still a rare tumor. Vast majority become apparent before age of 3yrs. It results from malignant transformation of primitive retinal cells before final differentiation. Presentation is most commonly(60%) with leukocoria and strabismus; other presentations include secondary glaucoma, anterior segment invasion, orbital inflammation, proptosis, metastasis, and through detection on routine exam.