Mistakes in the diagnosis of children intraocular tumors

Summary The first mistake is to consider normal a unilateral strabismus or a leucocoria in a baby or a child and don't performed a dilated funduscopy. Retinoblastoma is the first ocular tumor in childhood and often late diagnosed because professionals (pediatrician, GPs, or ophthalmologists) didn't believe parents that notice a white reflect in their kid's pupil. Clinically, on dilated fundus, one or more white tumors can be associated with exudative retinal detachment or subretinal or vitreal seedings. The disease can be unilateral or bilateral. Several forms can be more difficult to diagnosed (infiltrative retinoblastoma, inflammatory cellulitis associated with advanced retinoblastoma, neovascular glaucoma with buphtalmia associated with advanced retinoblastoma. The more frequent disorder that can stimulate retinoblastoma is coats disease especially in advanced forms, persistent hyperplastic primary vitreous, and other rare tumors (medulloepitheloima, leiomyoma or melanoma). The proper diagnosis can be done in referral centers with team trained to deal with these diseases and sometime with the help of US echography or MRI of the eye. In case of suspicion of ocular tumor, the child must be referred in emergency in a specialized center.