Opthamologist or Optometrist for 2 year old's white pupil?

[sunlilies]

Upon looking through some photos I noticed my 2 year old son to have a couple of photos with a white pupil in his right eye.  I took him to his pediatrician who examined his eyes and noted that there was a red relex in both eyes but that it wasn't as prominent in the right eye.  He recommended that we see an opthamologist just to be safe.  I tried to make an appointment with several opthamologists in our area but their first available appointments aren't for several weeks out.  Worried and desperate for quick answers, I scheduled a same day appointment with an optometrist.  He dilated my son's eyes and used an indirect ophthalmoscope to look into his eyes at various angles.  He said he saw no white reflex and that aside from having a prescription in the right eye, my son has healthy eyes.  My question is: Should I keep the appointment with the opthamologist to confirm that there are no problems or was the exam the optometrist performed thorough enough?

[Houman Vosoghi, MD]

Yes.  I don't see what further testing would be necessary.  A check for refractive errors would be important in my opinion in a two year old as well to make sure there is not a great difference between the two eyes (which may mean a need for glasses).  At that age, I would only trust a pediatric ophthalmologist to do it accurately a retinoscopy.

HV

[sunlilies]

Thank you for answering my question, Dr. Vosoghi.  I certainly do not want to take a chance with my child's vision.  I just wasn't sure, based on the difference between the two professions, if the test the optometrist performed was thorough enough.  What more would an opthamologist do in terms of tests if his/her initial assessment (dilation and inspection of the eyes) was in agreement with the optometrist's results and if so, would there be a need for further testing?  Is the absence of a white reflex upon dilation and careful inspection of the eyes by a skilled opthamoloigst adequate enough to rule out retinoblastoma?  Thank you again.  

[Houman Vosoghi, MD]

Ideally, you should be seeing a pediatric ophthalmologist to be sure.  I wouldn't take a chance with my child's vision.  I'm surprised none of them fit you in for a "white pupil."  Not something you would want to wait on (although after the optometrist's exam it's likely OK to wait).

HV