The nurse is completing a health history with the parents of a 6-month-old infant with retinoblastoma. Which symptom should the nurse expect that the parents have observed?

Rationale: A. The infant's eye appears to be protruding: Protrusion of the eye, or proptosis, is more often linked to orbital tumors, severe infections, or trauma rather than retinoblastoma. Retinoblastoma primarily affects the retina inside the eye, not surrounding orbital structures. B. The infant tugs and pulls at one ear: Ear pulling is more commonly associated with otitis media or ear discomfort. This behavior is not connected to retinoblastoma and would not be expected in a history related to an intraocular tumor. C. The infant always keeps her eyes tightly closed: Persistent eye closure could be a sign of photophobia, eye irritation, or pain from corneal abrasions or infections, but it is not the hallmark presentation of retinoblastoma. D. One pupil appears white: A white reflex in the pupil, known as leukocoria, is a classic finding in retinoblastoma. Parents may notice this when light shines in the child’s eye, where one pupil appears white instead of the normal red reflex.