tommyk
04-09-2006, 06:34 PM
Hy 2120 112% chance of being on your test (View a picture of this dx.) Big TIME!
A young woman named Britney Spears again, comes with her her 18-month-old son. It is immediately noticed that one of the baby's pupils is white, while the other one is black. When asked about it, the mother relates that she saw that curious situation for the first time 1 week ago, but since the baby was otherwise asymptomatic, she did not think it merited special attention.
1-Reassurance
2-Get Genetic Testing for an albino gene
3-Consult for possible retinoblastoma
4-Give Gentamicin eye drops and re-examine in two weeks.
5-Give “Visine” eye drops and eye wash
6-Refer to eyeglass doctor to get a black contact lens
a) #3……A newly developed white pupil in a child raises the possibility of retinoblastoma (a deadly dx). This tumor is so deadly that immediate diagnosis and treatment are imperative. Ignoring the finding could prove to be lethal, and the same can be said for any delays caused by pursuing bizarre considerations, such as looking for albinos in the family or treating for an eye infection that is not there. I said she had NO other symptoms! It could be argued that if an ophthalmologic consultation is obtained, even if it is for a wrong diagnosis, the true nature of the problem will eventually be recognized. But an appointment to check for cataracts (which would have been present since birth) will not be made with the same urgency that the situation requires.
A young woman named Britney Spears again, comes with her her 18-month-old son. It is immediately noticed that one of the baby's pupils is white, while the other one is black. When asked about it, the mother relates that she saw that curious situation for the first time 1 week ago, but since the baby was otherwise asymptomatic, she did not think it merited special attention.
1-Reassurance
2-Get Genetic Testing for an albino gene
3-Consult for possible retinoblastoma
4-Give Gentamicin eye drops and re-examine in two weeks.
5-Give “Visine” eye drops and eye wash
6-Refer to eyeglass doctor to get a black contact lens
a) #3……A newly developed white pupil in a child raises the possibility of retinoblastoma (a deadly dx). This tumor is so deadly that immediate diagnosis and treatment are imperative. Ignoring the finding could prove to be lethal, and the same can be said for any delays caused by pursuing bizarre considerations, such as looking for albinos in the family or treating for an eye infection that is not there. I said she had NO other symptoms! It could be argued that if an ophthalmologic consultation is obtained, even if it is for a wrong diagnosis, the true nature of the problem will eventually be recognized. But an appointment to check for cataracts (which would have been present since birth) will not be made with the same urgency that the situation requires.