Worried about my toddler

[clair_witch]

When my daughter was born in July 2007 I noticed immediately that one pupil never seems to dilate as much as the other. I seen my doctor who reassured me it was normal and that a difference in pupil size would often correct itself at a later date.

A recent photograph of my daughter has shown one red eye and one white eye. I have seen other photos with more of a slight whiteness to them, but this photo is the most noticeable by far.

I have decided to get her an appointment at the doctors first thing tomorrow just to get things checked and be on the safe side, but tonight I find myself worrying like mad and I keep looking back at the photograph.

Here is a link to the photos.

http://i50.photobucket.com/albums/f334/clair_...

http://i50.photobucket.com/albums/f334/clair_...

What do you think? I'm hoping it's just the effects of the flash and nothing sinister at all, but I can't help but worry. The first photo shows a brighter whiteness and in the second it looks kind of more cloudy.

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

We are all most grateful. Thank you for the follow up.

JCH MD

[clair_witch]

We went for our appointment today and I am very, very pleased to say Lilah got the all clear. The doctor said he could see the light reflecting off her retina perfectly and they measured a difference of 1mm in pupil size.

He said it was a mild corneal (or cornea/corea) that was causing it and said she might have a slightly droopy eye (which she does, especially when she's tired) and he also said as she gets older she may lose some colour in that eye, but all in all a healthy little girl and no follow up appointments required.

Thank you so much for all your advice. You have been such a help to us and we are extremely grateful.

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

Well I hope it will serve your child in a timely fashion. We'll be waiting to hear from you and remember your child and family in our prayers.
JHaganMD

[clair_witch]

Yes, I live in the UK and there's often huge waiting lists for hospital appointments and to see specialists etc... Our National Health system is in a terrible state.

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

Obviously they share my concern. I have had stories like this where the child or adult patient with an ultraserious problem did wait 3-6 months to be seen. Do you like in the UK? Canada? that's where the most horror stories about inablity to see a specialist or get an MRI or a joint replacement or cataract surgery seem to come from.

JCH MD

[clair_witch]

I have been to see the GP thiis morning and before I even got to the doctor's surgery he had looked at Lilah's photos and had sent them off to the eye casualty.

The consultant has had a look and wants to see her Wednesday morning. I a very surprised they fitted her in so quickly, our eye hospital usually has a waiting list a mile long and my Mum's consultant (she has glaucoma) wanted to see her back in 6 weeks, yet there was no appointments for 8 months.

I guess I am in for  a worrying few days. Thank you so much, you made me realsie how important this was and I feel awful for dismissing it it the flash.

I will update you once we have seen the ophthalmologist on Wednesday.

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

Until then.
JCH MD

[clair_witch]

I certainly hope it turns out to be the latter cause.

I have just emailed copies of the photographs to my GP surgery, so he should be able to see my concerns.

Thank you so much for your help, I will pop back tomorrow after our appointment and update you.

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

Another thing that might cause the pupil and the white appearance that is less ominous is a "coloboma of the iris and retina" that is a abnormality of eye formation where the bottom seam of the eye doesn't unite. It need not be associated with poor vision or require treatment.

Wish you the best possible findings.

JCH MD
Kansas City, Missouri, USA

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

Can't you print them out? Can you e mail them to a friend or commercial firm (like a copy shop or photo lab) that can make you copies. Does the GP have an office e mail? There has to be a way to get the photos to the physicians.

JCH MD

[clair_witch]

Thank you very much for your reply. To be honest I am not normally much of a worrier, but this photo sent shivers down my spine. I live in the UK and will be making an appointment to see my GP first thing tomorrow. I will keep you updated and let you know what they say.
I wish I had a copy of these photos to take with me to show him, maybe I could mail them to the surgery.
Thanks again, I will be in touch.

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

Clair_withc   I have looked at both pictures and they are very concerning. In the one photo the left eye has a total white reflex. That can indicate major problems in the eye like cataract, tumors, inflammation, malformations or misalignment.  In the other picture I don't see a white reflex but it looks like the eyes are not straight and have an outward drift.

Please contact your pediatrician tomorrow morning EARLY and ask for an emergency referral to an ophthalmologist ideally a pediatric ophthalmologist.

You can tell they you've noted a white pupil reflex on a photograph and that this photo has been viewed on the internet by a board certified ophthalmologist at a website sponsored by the American Academy of Ophthalmology.

PLEASE let me know what the examination shows so I and all those that read this post will know that hopefully this is one of the minor causes and not a major one.

Please repost to confirm you have received this message.  You can also go to www.aao.org and look for a pediatric ophthalmologist near you. Do not be put off for an exam in 3-6 weeks.

John C. Hagan III MD, FAAO, FACS

[clair_witch]

Sorry the links don't appear to be working. Here they are again.

http://i50.photobucket.com/albums/f334/clair_witch/629024ae.jpg

http://i50.photobucket.com/albums/f334/clair_witch/0f397b4e.jpg