What is an appropriate management step for a child with a wandering right eye and leukocoria?

In cases where a child presents with symptoms such as a wandering right eye (strabismus) and leukocoria (a white reflex in the pupil), it raises concern for potential underlying conditions, notably retinoblastoma. This cancer of the eye typically presents in young children and may manifest as leukocoria.

Ordering a CT scan is appropriate because it allows for imaging of the eye and surrounding structures to rule out retinoblastoma or other serious conditions. The CT scan can provide critical information regarding the presence of any tumor and the extent of disease, which is essential for guiding further management.

Immediate surgery could be considered in certain situations, but it is generally not the first step without confirmation of a diagnosis. Patching therapy and vision therapy are interventions more suited for amblyopia and do not address the acute concern of potential malignancy indicated by leukocoria. Therefore, imaging is a crucial first step to ensure that any significant pathology is identified and treated appropriately.