A red reflex test detects cataract and retinoblastoma. Both conditions require urgent referral, however cataract is much more common.
Within the United States, the incidence of retinoblastomas is 11-12 cases per million live births. The incidence of visually significant cataract is 300-400 per million live births (3-4 per 10,000).
The red reflex test is commonly performed during the first days of birth as part of routine vision screening. The examiner shines a light into the infant’s eye in a darkened room, and both eyes should reflect a symmetric red reflex. The test can be recreated informally at home using the flash of a camera, causing the commonly recognized red eye effect.
An eye or eyes that lacks a reflection or reflects white, are referred to an ophthalmologist immediately who can diagnose the condition. Lack of a red reflex is a medical emergency.
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