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Alaska Blind Child Discovery

A cooperative, charitable research project to vision screen every preschool Alaskan

Red Reflex in Infants


A devastating form of amblyopia is "deprivational" amblyopia due to dense congenital cataracts. AAP recommends that all newborns have a red reflex test to rule out opacities between the cornea and the retina. Any infant with large eyes, excess tearing and cloudy corneas might have another blinding condition called Congenital Glaucoma. An infant with consistently white pupils (called "LEUKOCORIA") might have a retinoblastoma tumor.

Red Reflex testing is performed with a direct ophthalmoscope in a dim room. If the baby's lids don't open sufficiently, then an Alfonso lid speculum can be used by the pediatrician to assure a normal red reflex screening.

Red Reflex testing in infants resembles the Enhanced Bruckner Test.

AAP Policy on Red Reflex


Congenital cataract causing amblyopia left eye

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iPhone free CRADLE app for Leukocoria  
While white objects in the retina can cause "leukocoria:" it is much more common for other conditions such as de-focus or misalignment- this is the reason for photoscreening. If a white lesion like retinoblastoma is in the periphery of the retina, a child will repeatedly give equal, normal red reflex test. However if a parent or pediatricians notes consistent white pupils, that child should be referred promptly for a confirmatory exam.  


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