The red reflex test is used to detect eye abnormalities in babies and should be done periodically during their first few years of life. Abnormalities can indicate serious conditions such as cataracts, glaucoma, or retinoblastoma, and should be addressed immediately.
Red reflex refers to a reddish reflex that is seen when an ophthalmologist shines a light on a patient’s healthy eye. This reflex occurs when light from a doctor’s instrument, called an ophthalmoscope, travels through the pupil and is reflected by the cells in the retina at the back of the eye. The clear transmission of this reddish light indicates that the eye is healthy, while the lack of a red reflex or the presence of spots or asymmetries between the two eyes can indicate a variety of different eye abnormalities.
A red reflex test is recommended for all babies and should ideally be done for the first time between the first two weeks and two months of life. The test should then be repeated periodically as needed during the first few years of the child’s life. Most anomalies detected by this test have a significantly improved outcome when detected early, and for this reason, this test is required by law in some states. The test should be performed in a dark room and the doctor should shine the light into a child’s eye from a distance of about one foot (3m).
The most common abnormalities observed in this test are the production of white light and/or whitish spots or no light, rather than the typical reddish color. This usually indicates that something abnormal with the eye is blocking the transmission of light through the pupil and retina. The absence of light is usually caused by some type of bleeding, or hemorrhage, in the eye, but it can also be caused by any large foreign object in the eye that is blocking light transmission. An asymmetric result can be a sign of serious developmental abnormalities, but it can also simply indicate that the two eyes have very different refractive errors.
Abnormal white color or white spots can be caused by cataracts or glaucoma. They can also be caused by retinal abnormalities such as infections in the retina or retinal detachment. All of these conditions can threaten your baby’s vision, and for this reason, any type of red reflex abnormality should be addressed immediately.
Another abnormality that can cause whitish light or spots on the red reflex test is the presence of retinoblastoma, or an eye tumor that usually occurs in young children. This cancer has a tendency to run in families, but it can also occur in children who have no family history of the condition. It may be possible to remove this tumor with laser surgery, although larger and more aggressive tumors can cause eye loss if this is the only way to stop the cancer. The outcome for retinoblastoma is usually good if caught before the tumor has had a chance to spread outside the eye, but the prognosis is less favorable after it has spread.
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