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 as well as on an ongoing basis at pediatrician visits. 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.
What to Expect from your Ophthalmologist consult?
The ophthalmologist will dilate your child’s eye(s) using a drop or combination of drops. drop relaxes the muscles in the eye which lets the doctor to examine the inside of the eye. Though they may briefly sting, the sensation will pass quickly.
Because children require stronger drops than adults, a child’s eyes can stay dilated for longer than 24 hours. Common side effects, including light sensitivity and blurry vision, will subside over that period.
After 30 minutes have passed, the time needed for dilation to take place, the ophthalmologist will inspect the eye with a retinoscope. He will determine the size, type, and visual impact of the cataract and whether it occurs in one eye or both. This part is usually fairly quick.
If the cataract is visually significant and surgery is recommended, the details of that will be discussed. For more information check out our surgery subsection, including questions you should ask at pre-op, when to time the surgery, and who should perform it.
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