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Pupillary Light Reflex

Aka: Pupillary Light Reflex, Red Reflex, Leukokoria, White Pupil, Bruckner Test, Cat's Eye Reflex
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  1. Indications
    1. Screening in all children under age 3 years
  2. Technique
    1. Pupil visualized with direct ophthalmoscope at 1-2 feet
    2. Perform in darkened room
    3. Pupil Dilation if reflex poor (e.g. pigmented fundus)
      1. Tropicamide (Mydriacyl) 1% one drop per eye or
      2. Phenylephrine (Neo-Synephrine) 2.5% one drop/eye
  3. Normal Findings
    1. Light reflex normally appears red (Red Reflex)
    2. Normal if red-orange or even orange-yellow
  4. Abnormal: Leukokoria (White Pupil reflex)
    1. Requires urgent ophthalmology referral
    2. Causes
      1. Retinoblastoma (most important and urgent)
      2. Corneal Opacity
      3. Hyphema or other anterior chamber fluid
      4. Congenital Cataract
      5. Vitreous opacity
        1. Primary persistent hyperplastic vitreous
      6. Retinal disease
        1. Toxocariasis (granulomas involving Retina)
        2. Retinal Detachment
        3. Retinopathy of Prematurity
        4. Coat's Disease (subretinal fluid, lipid collection)
  5. References
    1. Berson (1987) Ophthalmology Study Guide, AAO, p. 106
    2. Essman (1992) Am Fam Physician 46(4):1243-52
    3. Mills (1999) Am Fam Physician 60(3):907-16
    4. Shields (1991) Retina 11:232-43
    5. Simon (2001) Am Fam Physician 64(4):623-8

Bruckner test (C1302982)

Concepts Diagnostic Procedure (T060)
SnomedCT 400922006
English Bruckner test (procedure), Bruckner test
Spanish prueba de Bruckner (procedimiento), prueba de Bruckner
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Red reflex (C0278244)

Concepts Finding (T033)
SnomedCT 43408002, 301958008
English red reflex, Fundus reflex, Red reflex, Observation of red reflex, Red reflex present, RR - Red reflex present, RR - Red reflex, Finding of red reflex, Red reflex (finding), Finding of red reflex (finding)
Spanish cono de luz, hallazgo relativo al reflejo rojo (hallazgo), hallazgo relativo al reflejo rojo, reflejo del fondo de luz, reflejo luminoso, reflejo rojo (hallazgo), reflejo rojo
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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