Red Reflex

This is another picture that I have found looking back through photographs of M.

This photograph clearly shows an abnormal red eye reflex.  Her left eye is red, exhibiting red reflex, in this picture because the left eye has no cataract.  Her right eye shows no red, and this is because that eye has the cataract.  Check out a previous post and picture of red reflex.

Any irregularities in this red reflex, or any differences between the red reflexes in the eyes, are reasons to make sure your child is seen by a doctor as soon as possible.  The sooner a cataract is found in an infant, the better the outcomes.  Early intervention is what counts.

Red Eye Reflex - Congenital Cataract

Another sign of cataracts is the absence of a red eye reflex.  It is exactly as it sounds.  When you take a picture of your child with a camera that allows red eye to show up, both eyes should have red eye.  If an eye lacks the red eye look in pictures, or if the red eye looks different between the eyes, then there could be an abnormality.

Red eye reflex should be screened for by a family physician at regular visits during a child's early months of life.  The earlier an identification of an abnormality in a child's eye the more promising the visual outcome will be.

The picture below shows M the morning of her cataract removal surgery.  M's left eye shows the red pupil, whereas her right eye shows no red in it.  Her left eye exhibits this red eye response, which is what is supposed to happen when there is no cataract there.  Her right eye does not show any red because it has the cataract in it.

M's left eye is clearly showing a red eye reflex, by appearing red in this photo.  There is no red in her right eye because it has the cataract.

All infants are supposed to be screened for a red eye reflex within the first 2 months of life, and thereafter.  It's supposed to be performed by someone who is trained to do that (could be a family physician, pediatrician) and is supposed to be in a darkened room.  Just ask your physician if they are looking for it - at least then they'll know that they should if they haven't or be able to tell you what they are looking for if they are doing it.

The American Academy of Pediatrics has an article online: Red Reflex Examination in Infants.

http://pediatrics.aappublications.org/content/109/5/980.full

It gives a brief outline on what should be done by physicians when examining infants for the red eye reflex.

A Sign We Missed

M was born with a cataract in her right eye and we didn't notice it was there until she was 9 months old.  Looking back we can now see it in almost all of her pictures.  Her right pupil is cloudy, and definitely not as black as her left pupil.  Her right eye hadn't 'gone lazy' yet and there seemed to be no 'jump-out-at-you' signs.

The above picture was taken when she was just about 3 weeks old.  You can see the cloudly white part in the right eye.  The left eye is all black and the right eye is not.

This second picture was taken just before she turned 2 months old.  You can see the white circle that is in her right eye pupil.  Don't you love her hair?!  It was wild since birth - very dark and just stood straight up no matter what you tried!

At the time  we weren't looking at her eyes specifically and just didn't notice that they were different.  Now looking through all of our pictures it's all that we can see.  I rationalize to myself and think that if I had noticed I would have thought that they were just different flashes from the camera, or reflections of light from the flash.  Unfortunately, they weren't...  Also, looking at the pictures gives a clearer image of the cataracts because of the light reflections perhaps.  When you were looking at her in person they didn't look the same as in the pictures.