A 4-YEAR-OLD boy was referred to us for the evaluation of leukocoria ("cat eye reflex") in the left eye. His mother had originally noticed an abnormal light reflex approximately 4 months earlier. The patient was otherwise healthy and he had not noticed the decreased vision in his left eye. There was no family history of ocular tumors.
Examination results showed a white fundus reflex in the left eye (Figure 1). Visual acuity was normal in the right eye and he could only appreciate hand motions in the left eye. A large, white, opaque mass covered the inferior portion of the left retina. Abnormal blood vessels were present on the surface of the lesion and seeds of material were floating in the vitreous cavity. The optic nerve was not visible. The right eye was normal. A computed tomographic scan showed a mass in the posterior portion of the left globe (Figure