The Red Reflex Test and Leukocoria in Childhood.

Gustavo Rocha, Joana Santos Oliveira, Sara Catarino, Augusto Magalhães, Renato Santos Silva

Journal: Acta medica portuguesa 2024;37(9):638-646

PMID: 39074051

Abstract

The red reflex test, performed using a direct ophthalmoscope, serves as a critical diagnostic tool in identifying various ocular conditions. These conditions encompass retinal anomalies (such as retinoblastoma, Coats disease, retinopathy of prematurity, familial exudative vitreoretinopathy, myelinated nerve fibers, ocular toxocariasis, ocular toxoplasmosis, retinochoroidal coloboma, astrocytic, and combined hamartoma), vitreous abnormalities (including persistent fetal vasculature), lens issues (like cataract), anterior chamber and corneal conditions (comprising dysgenesis of the anterior segment, congenital glaucoma, birth trauma), and tear film disturbances. During this examination, the presence of leukocoria, characterized by a white pupillary reflex, can suggest the presence of underlying conditions. Any suspicion of an abnormal red reflex test warrants immediate evaluation by a qualified ophthalmologist. This article primarily underscores the paramount importance of the red reflex examination, not only to identify potential sight-threateningbut also life-threatening conditions. It delves into the most common causes of leukocoria in childhood and offers insights into a comprehensive diagnostic approach. The target audience for this article includes pediatricians, primary care clinicians, and ophthalmologists, all of whom play a pivotal role in the early detection and intervention of these critical eye disorders.

Address: Department of Ophthalmology. Unidade Local de Saúde de São João. Porto. Portugal.; Pediatrics Department. Unidade Local de Saúde de São João. Porto. Portugal.; Department of Ophthalmology & Reference Centre of Inherited Metabolic Diseases at the Pediatrics Department. Unidade Local de Saúde de São João. Porto. Portugal.; Department of Neonatology. Unidade Local de Saúde de São João. Porto. Portugal.; Department of Ophthalmology. Unidade Local de Saúde de São João. Porto.; Department of Surgery and Physiology. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.

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