retinoblastoma

hello, i need a debate settled.  one person told me that the "cats eye" reflex is NOT always present in someone that has the disease.  i said it would be evident in a 99% of the pictures that someone took of the suspected eye.  i said sometimes light, angles, flashes, etc. can sometimes cause this reflex in a healthy person.  i also said you would see a vast majority of pictures with this reflex and not the usual "red eye" photos.   could you explain this better?  if someone took 10 photos and the eyes were "red reflex" and there was one with a white or diff. eye, wouldnt it just be contributed to another factor, not a disease?  thanks for any input.  oh and by the way, with my kids they are checked once a year by the eye dr. and periodically the reflex is checked by their ped.

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

1. An eye can have a retinoblastoma without a white pupil reflex. It's due to small size or located in the far periphery of the eye.
2. Other thanks can cause a white reflex: cataracts, an eye filled with pus, a condition called persistent primary hyperplastic vitresous, large retina coloboma, etc.
3. A healthy eye should NOT produce a white reflex.

JCH III MD

[ny2125]

i have seen in various photos of people a white reflex or not a true red reflex.  but their other photos there will be a red reflex.  can angle and flashes cause this too?  and would someone w/retinoblastoma be able to see with that eye or have other tell-tale issues?  thanks.

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

Many retinoblastomas occur in intants and they can't tell adults what the problem is. If a tumor is small and peripheral it may be assymptomatic.

JCH III MD

[ny2125]

i had a pic of my nephew with a white reflex, but the other pics showed red reflex.  there were a lot of people taking pics at the same time of that certain pic.  then he went to the dr. a week later and his eyes were fine.  i see pics of sports players that show white reflex in action from the newspaper, they are football or basketball players.  its just confusing.  isnt retinoblastoma more common in kids younger than 5?

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

retinoblastoma is usually discovered by age 5.

JCH III MD

[ny2125]

and wouldnt the white reflex have to be consistent if the retinoblastoma is one that is showing a white reflex?  wouldnt an exam by a ped. show it too if there were signs of eye trouble?  i realize an eye dr. is the best route, but most peds. do check eyes for overall health too.  and i guess this is a rare condition too?  sorry so many ?'s, but i appreciate your time and responses!  thanks.

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

No many eye examinations will NOT show a retinoblastoma because it's small and to see it the eye will have to be dilated and an indirect ophthalmoscope used.

Use Google IMAGES and search retinoblastoma. If you look at enough images you'll se a small one.

I think we've just about beat this subject to death and I'm signing off.

JCH III MD