Abnormal Red Reflex: Etiologies in a Pediatric Ophthalmology Population

Abnormal Red Reflex

Article from: Clinical Pediatrics – SAGE Journals member of the Committee on Publications Ethics.

Year of publication: 2020

Authors: Sophie Y. Lin, Kimberly G. Yen, MD, Huirong Zhu, PhD, Alexis Moisiuc and Madhuri Chilakapati, MD.

Photo credits: British Journal of General Practice

About the paper:

The paper discusses the common ocular conditions associated with an abnormal red reflex (ARR) and emphasizes the importance of timely referrals. The study was conducted on 152 patients with a chief complaint of ARR seen between March 1, 2013, and March 31, 2018, in a tertiary care pediatric ophthalmology clinic. The most common ocular pathology was a refractive error requiring correction with glasses, and visually significant refractive error was the most common cause of an ARR. Although RB is a relatively uncommon diagnosis in patients who present with ARR when compared with other diagnoses, it remains a chief concern, especially leukocoria. The study concludes that pediatricians should continue to refer patients with an ARR conservatively as treatments for many ARR-associated pathologies are time-sensitive and require early intervention to prevent amblyopia or other causes of irreversible vision loss. With improved characterization of ARR diagnoses and the development of new technologies, pediatricians will be better able to manage and refer patients in their clinical practices with confidence.

About MD Eyecare in this paper:

“Leukocoria is often noticed by parents or relatives on flash photography, but previous literature suggests that this finding is not a useful predictor of pathology and cannot be reliably used for red reflex screening. With the advent of new technologies, however, improved methodology in smartphone- based applications and artificial intelligence can enhance the detection of RB, such as MDEyeCare”.

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