Red Reflex

Our resolve NOT to look things up lasted approximately 5 minutes... it lasted until I could turn on the smart phone and start googling.
What is this red eye reflex?  This was a term that neither one of us had ever come across before.  We knew that the pediatrician always checked the kids' eyes during well-child checks, but we always thought it was to check that the pupils were round and equally reactive.  We have since learned that there are MANY reasons why they check the eye:  they check the pupils, the cornea's appearance, they check visual acuity, ability to fixate on objects, alignment, and they check for a red reflex or presence of leukocoria to name just a few.
The red reflex

The red reflex test or "Bruchner's test" can detect many different ophthalmologic problems in children and should be performed as part of a normal newborn screening.  In normal eyes, the practitioner will shine a light into the eye and will see a red reflection with the ophthalmoscope.  This is also what causes "red eye" in pictures.  From some stories we read on the internet, this is one of the ways their child's problems were diagnosed, parents would notice that the eyes didn't match in pictures.  This isn't something we noticed before our pediatrician visit... but looking back (hoping to find 2 shining red eyes) we saw what she saw:


His left eye show no red reflex



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So, Tommy had no red reflex (or rather, he had leukocoria, which means white pupil) in his left eye.  The pediatrician casually mentioned the word "cataract".  She did not mention the other horrible things it could be such as retinoblastoma, chorioretinal coloboma, persistent hyperplastic primary vitreous, endophthalmitis, Coats disease, retinal detachment, or other seemingly scary things.  We scared ourselves silly googling information (even though we knew better), then scared ourselves more by trying to dig into the scientific literature.  The literature was perhaps scarier because we read that the incidence of retinoblastoma was not comfortably (or significantly) different than a cataract in the literature we could find.

We spent 5 days torturing ourselves with all of the terrible possibilities.  Did he have cancer?  Would he lose his eye?  Would he be able to see?  We cried, we prayed, and debated about how many other people to torture with this information.  In the end we told a few close friends and just a few family members.  It got to the point where I just had to look at him and I would cry... so telling people about this just seemed worse, it was like reliving the terror.  We were sleep-deprived, had a house full of sick kids, and I was post-partum... looking back, I still am not sure how we survived that weekend!  This was the only positive thing about having a house full of sick kids- they provided a much-needed distraction from our own imaginations.