White pupil in picture

We just noticed in the attached picture of our 5 month old that one of her pupils is white.  It was especially concerning since it was taken indoors and no one else has red or white eyes in the picture.  We've scheduled an appt with our pediatrician for tomorrow morning, but are worried sick tonight.

We've never noticed this in any other pictures.  How worried do we need to be?

[John C Hagan III, MD, FACS, FAAO]

A "white pupil" in a child is always an emergency and you need to be referred to a pediatric ophthalmologist ASAP. There are some very serious things that can cause this including a malignant tumor (retinoblastoma), malformation of the inside of the eye, pediatric cataract and some others

HOWEVER there are other less serious things than can cause this and the last three parents that came to these eye forums and posted pictures with white reflex got GOOD news from the ophthalmologist.

Please let us know what the exam by the Eye MD showed.

JCH MD

[scaredmommy09]

Dear Dr. Hagan,
We recently discovered a similar picture of our son who is now 7 months old. When I looked back at old pictures, I began to notice it in several of them. Generally it was in the left eye but from time to time it was in the right eye. It always seems to happen when we have the red-eye correction feature turned ON.

Based on several internet posts, we have taken lots of pictures of him in a darkened room with this feature turned OFF and the pictures always come back normal, with vivid red reflex in both eyes.

Of the (literally) hundreds of pictures we have of the baby, this weird white pupil has shown up in about 20 or 25, I think.

We scheduled an appointment with our pediatrician who examined the baby and said everything looked normal but they referred us to a pediatric ophthomologist just to be safe.

We saw her on Monday and she took a few pictures of his eyes using a digital camera, noting normal red reflex. She also dilated his eyes and said that everything looked fine and that it might just be something with our camera. She noted that some babies eyes don't open very wide when dilated but said that the baby's had opened very wide and she was able to see them well.

However, someone later mentioned to me that they were surprised they hadn't taken a picture of the retina. He is also rubbing his eyes a bunch which is a little concerning (though I suppose that could be related to his crazy eczema).

So, long story short -- I am just wondering if I should still be worried and get a second opinion since I have never seen our camera do this to anyone else's eyes. I really liked the doctor and am inclined to think everything is OK -- I just don't want to miss anything when it's something so important.

Is there any other explanation about what would be causing this white reflection in just his eyes? Are there any other tests you think she should have run? Or, should I just assume it's normal and move on??

Many thanks for your help,
A Scared First Time Mommy in Chicago.

[John C Hagan III, MD, FACS, FAAO]

Taking a picture of the back of the eye in a 7 month old can't be done without anesthesia. The exam your child received is adequate to say don't worry and that the reflex is just a funcition of light reflection with the red reflex compensation.

JC MD

[pepi79]

We took a photo wit HTC phone yesterday and noticed that one of my daughters eyes is with white reflection. I can not see it ona nay other photos and took several more after this shot with anothr camera, but again could not see anything. I am concerned, because the same eye started changing shape about a week ago, has redness which comes and goes on the inner side of the eyelid, also it becoems puffy after she wakes up. Is tehre anything to worry about?
Thanks!

[John C Hagan III, MD, FACS, FAAO]

Yes, in the one photos the pupil is whte. Coupled with your other observations about the child I would strongly suggest your pediatrician refer her to an ophthalmologist to determine for certain if any of these are problems.

JCH MD

[melrad]

Our son showed some white relfex in pictures.
We took him to the pediatrician who checked his eyes with a Ophthalmoscope.  She turned the lights off to do this. She told us that the eyes looked normal.  Should we be concerned about the white reflex in the pictures?

[John C Hagan III, MD, FACS, FAAO]

If the physician you saw was a pediatric ophthalmologist EYE MD and the pupils were dilated then that should   be enough to rule out the serious causes.

JCH MD

[kay_amelia]

Should I be worried if on a picture of my 7month old daughter one of her eyes are white? Please help

[John C Hagan III, MD, FACS, FAAO]

You should have the child see an ophthalmologist for a dilated pupil exam.  It is a symptom that demands an evaluation but the white reflex does not always indicate a problem.  Your pediatrician can refer you.

JCH MD