A prototype smartphone app helps parents detect early signs of various eye diseases in their children such as retinoblastoma, an aggressive pediatric eye cancer. The ComputeR Assisted Detector LEukocoia (CRADLE) app searches for traces of abnormal reflections from the retina called leukocoria or “white eye,” a primary symptom of retinoblastoma as well as other common eye disorders.
The app searches through family photographs for signs of leukocoria. The sensitivity, specificity, and accuracy of the prototype were determined by analyzing more than 50,000 photographs of children taken prior to their diagnosis. For children with diagnosed eye disorders, CRADLE was able to detect leukocoria for 80 percent of the children. The app detected leukocoria in photos that were taken an average of 1.3 years prior to their official diagnosis.
The effectiveness of traditional screenings during a general physical exam is limited, with signs of retinoblastoma via the detection of leukocoria in only 8 percent of cases. CRADLE’s sensitivity for children age 2 and younger surpassed 80 percent. Given the number of photos taken by family and friends and the variety of environments, there are multiple opportunities for light to reflect off the ocular lesions regardless of its location in the eye.
As the app’s algorithm has become more sophisticated, its ability to detect even slight instances of leukocoria has improved. Initially, the CRADLE app was used primarily to identify retinoblastoma — a rare eye disease that is the most common form of eye cancer in children up to age 5. So far, parents and some doctors have used it to detect cataract, myelin retinal nerve fiber layer, refractive error, Coats’ disease, and retinoblastoma.