- Newborns and Infants: During routine pediatric examinations to screen for congenital eye conditions.
How to Check the Red Reflex
- Environment: Dim the room lights to enhance visibility of the red reflex.
- Positioning:
- Position the patient at eye level, and sit approximately one meter away.
- Ask the patient to look straight ahead.
- Procedure:
- Direct the light of the ophthalmoscope into each eye separately.
- Observe the reflection of light from the retina through the pupil.
What to Look For
- Normal Red Reflex: A symmetrical, uniform red-orange glow reflected from the retina.
- Abnormal Findings:
- Leukocoria (white reflex): May indicate conditions such as retinoblastoma, congenital cataracts, or other retinal abnormalities.
- Asymmetry or Dull Reflex: May suggest media opacities like cataracts, corneal scars, or vitreous hemorrhage.
- Absence of Reflex: Could indicate a significant obstruction or retinal detachment.
White reflex causes
- Retinoblastoma
- Congenital cataract
- Hyperplastic vitreous
- Retinal detachment
- Retinopathy / retinopathy of prematurity
- Coloboma
- Toxocariasis – roundworm infection
- Always need referral to ophthalmologist
Retinoblastoma
- Most common ocular tumour of childhood
- Can be unilateral or bilateral
- Bilateral suggests hereditary trait
- Usually < 4 years
- Will need surveillance of the other eye
- Hereditary type also assocated with osteosarcoma, neuroectoderm tumours, melanomas
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