Can you diagnose eye diseases by looking at a photograph?

Screen Shot 2014-04-07 at 9.13.27 AMFox News recently covered a story about how a rare and serious eye condition was discovered on Facebook because friends noticed something strange when a mom posted a picture of her child. One of the child’s pupils was white.

A white pupil, otherwise known as leukocoria, may indicate a serious eye condition.

How is leukocoria observed?

Leukocoria occurs when the pupil is white instead of black. Leukocoria may be detected in a photograph when one pupil has an abnormal reflex or “white reflex” compared to the other eye having a normal “red reflex.” The red reflex is either absent or white with leukocoria due to an abnormal light reflection from the eye. If leukocoria is pronounced, the pupil may appear white while observing the other person. This is easier to inspect in a darkened room.

What is a red reflex?

A red reflex is the normal reaction when light enters the eye through the pupil. The retina absorbs most, but not all, of the light and what is reflected back is reddish-orange in color – the “red eye” you see in pictures.

How is leukocoria diagnosed?

Doctors of optometry use an instrument called a retinoscope to examine the eye to determine if that normal red reflex is present. An ophthalmoscope is used to view the inside of the eye. The doctor also dilates the eyes a in order to evaluate them more thoroughly.

What causes leukocoria?

Many conditions cause leukocoria including cataracts, retinal detachment, retinopathy of prematurity, retinal malformation, an infection such as endophthalmitis, retinal vascular abnormalities, and intraocular tumors such as retinoblastoma.

These are all serious eye conditions which may be a vision and/or life threatening emergency.

If a white reflex or leukocoria is detected, schedule an eye examination immediately.

What is the treatment for leukocoria?

The treatment is to manage the underlying condition.  Early treatment is crucial. Treating the underlying condition promptly can save both vision and a person’s life.

~Melissa Barnett, OD, FAAO
California Optometric Association
http://eyehelp.org
http://www.coavision.org

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