**Question:** The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit, there is calcification seen within the globe. The most likely diagnosis is –

A. Retinoblastoma
B. Corneal calcification
C. Calcification after trauma
D. Congenital calcification

**Correct Answer:** D. Congenital calcification

**Core Concept:**

In children, the calcification of the eye (globe) is primarily observed in congenital conditions. Retinoblastoma is a malignant tumor of the retina, which is not associated with calcification. Corneal calcification is a rare condition and usually seen in adults. Traumatic calcification is typically seen in association with a history of ocular trauma.

**Why the Correct Answer is Right:**

The correct answer is "Congenital calcification" because the calcification is present from birth or develops early in life, which aligns with the history of a white reflex from one eye for over one month. This type of calcification is commonly observed in conditions like retinopathy of prematurity (ROP) or coloboma, which are congenital anomalies.

**Why Each Wrong Option is Incorrect:**

A. Retinoblastoma: This is a malignant tumor of the retina, which is uncommon in children under 2 years of age. Calcification is not a typical feature of retinoblastoma.

B. Corneal calcification: This is a rare condition in children and usually occurs in adults. It is not the expected finding in a child with a history of a white reflex from one eye.

C. Traumatic calcification: Calcification following ocular trauma is commonly observed in adults, not in a 1.5-year-old child presenting with a white reflex. In this case, the history and imaging findings suggest a congenital condition.

**Clinical Pearl:**

Congenital calcification of the eye globe is a differential diagnosis to consider in the presented case, especially when considering the history of a white reflex from one eye. This condition can be associated with various ocular anomalies, such as retinopathy of prematurity (ROP) or coloboma, which may require further evaluation and management.