Bilateral retinoblastoma presenting as leukocoria in unilateral eye: a case report

Retinoblastoma (RB) is the most common ocular tumour in childhood. Presentations include leukocoria, strabismus, decreased vision and painful blind eye. RB can have extraocular extension into the orbit and also metastasise distantly to the brain. We present the case of a 2-year-old child with RB in both eyes, advanced stage in left eye and early stage in the right eye. The left eye was treated with chemoreduction followed by enucleation. The histopathology examination of enucleated eye showed RB cells with no invasion of the optic nerve. The right eye was salvaged after treatment with cryotherapy and laser therapy. This case is significant as RB is a rare disease that was not previously reported from Bhutan. If a child presents with leukocoria, paediatricians and ophthalmologists should have a high suspicion of RB. Timely referral to an ocular oncologist and vitreoretinal specialist is crucial to save vision and the child’s life.