A 3 year old male presents with a sudden onset visual loss in left eye. Ophthalmological examination reveals strabismus and white pupillary reflex. Fundus finding is shown below.What is your diagnosis?
**Core Concept**
The patient presents with sudden onset visual loss, strabismus, and leukocoria (white pupillary reflex), which are classic symptoms of a retinal detachment or retinoblastoma. However, the fundus finding is crucial in making a definitive diagnosis.
**Why the Correct Answer is Right**
The fundus examination typically shows a retinal detachment or a retinal hole, which is a tear in the retina leading to fluid accumulation and separation of the retina from the underlying retinal pigment epithelium. This condition is often associated with retinal tears or lattice degeneration, which are common in young individuals. In this case, the presence of a retinal detachment with a retinal hole is a strong indication of a retinal break, which can lead to sudden vision loss.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because retinal detachment without a retinal break is known as a rhegmatogenous retinal detachment, which is not the case here.
**Option B:** This option is incorrect because retinoblastoma typically presents with leukocoria, but the fundus finding in this case suggests a retinal detachment or retinal break, not a tumor.
**Option C:** This option is incorrect because posterior vitreous detachment (PVD) is a common condition in older adults, and the patient's age and clinical presentation do not support this diagnosis.
**Clinical Pearl / High-Yield Fact**
Remember the "CRS" rule for retinal detachment: "C" for cataract, "R" for retinal break, and "S" for separation of the retina from the underlying retinal pigment epithelium.
**Correct Answer:** C. Retinal break.