Case Study 175 Retinoblastoma
RM is a 4-year-old child who was brought in by his mother for a routine prekindergarten examination. He was relatively uncooperative for the fundus examination. Indirect ophthalmoscopy was attempted, but only a fleeting view of either fundus could be obtained. The ophthalmologist justifiably felt that the examination was adequate in an otherwise normal child without specific complaints. He told the mother to bring him back in a year unless there were eye problems. A week later he fell off a chair and struck his head and experienced a brief loss of consciousness. A CT scan was obtained at the emergency room with no head trauma noted, but incidentally a calcified mass was detected in the superior temporal periphery of the left eye. He was referred to a pediatric ophthalmologist for fundus examination. This could not be adequately performed in the office, so an examination under anesthesia was later performed. A solid mass was noted in the superior temporal fundus of the left eye.