http://www.fpnotebook.com/
Pupillary Light ReflexAka: Red Reflex, Leukokoria, White Pupil, Bruckner Test, Cat's Eye Reflex
- Indications
- Screening in all children under age 3 years
- Technique
- Pupil visualized with direct ophthalmoscope at 1-2 feet
- Perform in darkened room
- Pupil Dilation if reflex poor (e.g. pigmented fundus)
- Tropicamide (Mydriacyl) 1% one drop per eye or
- Phenylephrine (Neo-Synephrine) 2.5% one drop/eye
- Normal Findings
- Light reflex normally appears red (red reflex)
- Normal if red-orange or even orange-yellow
- Abnormal: Leukokoria (White pupil reflex)
- Requires urgent ophthalmology referral
- Causes
- Retinoblastoma (most important and urgent)
- Corneal Opacity
- Hyphema or other anterior chamber fluid
- Congenital Cataract
- Vitreous opacity
- Primary persistent hyperplastic vitreous
- Retinal disease
- Toxocariasis (granulomas involving retina)
- Retinal Detachment
- Retinopathy of Prematurity
- Coat's Disease (subretinal fluid, lipid collection)
- References
- Berson (1987) Ophthalmology Study Guide, AAO, p. 106
- Essman (1992) Am Fam Physician 46(4):1243
- Mills (1999) Am Fam Physician 60(3):907
- Shields (1991) Retina 11:232
- Simon (2001) Am Fam Physician 64(4):623
|
|---|
| Concepts | Finding (T033)
|
| English | Finding of red reflex, Fundus reflex, Observation of red reflex, Red reflex, Red reflex present |
| Spanish | cono de luz, hallazgo relativo al reflejo rojo, reflejo del fondo de luz, reflejo luminoso, reflejo rojo |
| Credits | Derived from the NIH UMLS (Unified Medical Language System)
|
Navigation Tree
