Can Your Camera Help Diagnose Childhood Cancer?

A white, cloudy spot might be retinoblastoma

You snap a photo of your child using a camera with flash. When you look at the image, you spot something unusual — a white cloudy spot over one of your child’s eyes.

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This white cloudy spot might not just be a photo error, like red eyes. It sometimes serves as a sign of a rare but dangerous form of childhood eye cancer called retinoblastoma, says Arun Singh, MD, from Cleveland Clinic’s Cole Eye Institute.

If you see this white cloudy spot in your child’s photos, don’t delay. See an ophthalmologist, Dr. Singh says. “This is a sign that is worth checking out,” he says.

Why early detection matters

The white pupil that appears in certain lighting conditions — including flash photography — is called a leukocoria. It can be a sign of not only retinoblastoma but also a detached retina and other conditions.

But retinoblastoma is the most serious, Dr. Singh stresses.

Retinoblastoma is a cancer that grows in the developing eyes of young children, typically by ages 3 or 4. Treatment usually involves a form of chemotherapy, sometimes combined with laser therapy and other options.

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Most important, treatments work far better when doctors find retinoblastoma early. “We know the best outcomes happen in early stages of the disease,” Dr. Singh says.

When doctors find retinoblastoma in the very early stage, for example, there is a nearly 100 percent chance of saving a child’s eyeball through treatment, he says. But that drops to around 50 percent in the advanced stage and becomes near zero in late stages.

Child with leukocoria

This example shows a typical leukocoria of retinoblastoma (right eye).

If you see a white spot, should you always see a doctor?

Since early detection of retinoblastoma is so important, Dr. Singh and others urge parents to err on the side of caution.

The leukocoria, or white cloudy spot, isn’t the only sign of retinoblastoma. Sometimes a child may have strabismus, or “lazy eye,” as well as inflammation. But leukocoria is the most common sign. It’s so common there is even an app available for phones and other devices that may help in spotting it.

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The white cloudy spot on the pupil in photos isn’t always a sign of disease. But the chance of saving a child’s eye is worth a trip to the ophthalmologist, Dr. Singh says.

“If you see a white pupil in photographs, whether just in your photos or using an app, get it checked out,” Dr. Singh says. “Do this even if the white pupil doesn’t show up in all photos.”

An ophthalmologist will perform a dilated exam to look inside the pupil for signs of retinoblastoma. The doctor may also follow up with additional imaging.

If the signs of disease are there, your child can get sight-saving treatment — preferably sooner rather than later.

RELATED: Why You Need Regular Dilated Eye Exams

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