Leukocoria refers to a white or yellowish-white reflex in the pupil that becomes visible instead of the normal reddish glow. Parents often first notice this phenomenon in photos, when one pupil appears red and the other white. Leukocoria is always a warning sign to be taken seriously and requires immediate ophthalmological evaluation.
When light, such as the flash of a camera, enters the eye, it is reflected by the well-perfused retina and appears reddish. This so-called red reflex shows that the path of light from the cornea through the lens to the retina is clear. If this reflex appears white, it means that something in the eye is reflecting the light differently or blocking the light path.
Behind leukocoria there can be various, sometimes serious, diseases:
If you notice a white pupil reflex in your child (whether in photos, in bright light, or with the naked eye), you should consult an ophthalmologist immediately. Do not hesitate to make contact even outside regular office hours: if leukocoria is suspected, a prompt examination is necessary.
Practical tip: regularly check photos of your child, especially when the flash was used. There are now also smartphone apps that specifically look for a conspicuous pupil reflex. While these do not replace a medical examination, they can be a helpful clue.
The ophthalmologist checks the red reflex of both eyes and carries out a thorough examination of the fundus, in children often with the pupil dilated. Depending on the suspicion, further examinations such as ultrasound, MRI, or optical coherence tomography (OCT) may be necessary. The treatment depends on the underlying disease and is planned individually.
The red reflex test is part of the pediatric preventive examinations from birth. In addition, we recommend an initial eye examination in the first months of life, especially if eye diseases are known in the family.