A white reflection on a child's pupil suggests which condition?

The presence of a white reflection on a child's pupil, known as leukocoria, is a significant clinical finding that often indicates retinoblastoma. This condition is a malignant tumor of the retina that typically occurs in young children. The abnormal growth can interfere with light reflection in the eye, resulting in the characteristic white appearance when viewed in certain lighting conditions or photographs.

Retinoblastoma may present with additional signs such as strabismus or poor vision, but the critical feature that distinguishes it is the white reflection. Prompt recognition and referral for further evaluation are essential, as early diagnosis can allow for intervention that may preserve vision and is crucial for the child's overall prognosis.

Other conditions like unilateral cataracts can also cause abnormal findings in the pupil, but a cataract usually presents with other symptoms, such as blurred vision, and may not specifically result in a white reflection as prominently. Similarly, while unilateral strabismus can occur in various conditions including retinoblastoma, it does not directly cause a white reflection. Color blindness is a genetic condition affecting perception of colors and does not manifest as changes in the appearance of the pupil. Thus, retinoblastoma is the most directly associated condition with a white reflection in a child's pupil.