Watch out for white eyes in photos

As the only grandchild on her mother’s or father’s side, Emmy has been the focus of at least a thousand photos in her six months. So, if it’s true that each picture says a thousand words, her pictures have said around a million.

Adorable. Cute. Blue-eyed. Big smile. Playful. Those words are certainly expressed in the images I scroll through daily on my phone. But cancer? Cataracts? I was worried a couple of weeks ago that her pictures may be saying those words, too.

There’s an effect called leukocoria that every parent should look for in their child’s photos. It literally means “white pupil.” And it looks like a deer’s eyes when they meet brights on a rural highway.

It should concern parents because it can be a sign of a retinoblastoma (a lethal tumor inside the eye), cataracts and other serious eye diseases. I wrote a story about it several years ago and knew to look for it when I had my own child.

Emmy had several photos with the white-eye reflex during her first couple of months. They didn’t concern us too much because there were also several normal red-eye photos of her interspersed. Besides, she showed no sign of anything being wrong.

Then, a couple of weeks ago, my wife, Meredith, sent me the above photo of Emmy where both of her pupils are white. I got nervous. And, as all wise people do, I proceeded to look up everything I could find about it on the Internet.

What bothered me most was that all of the conditions associated with leukocoria are asymptomatic, meaning no symptoms are evident until diagnosis or it’s too late. The only semi-reliable way to tell if your child has those conditions is the photograph test.

Since Emmy didn’t pass that, I really started to worry. Really. My wife said I was paranoid, that my job makes me ripe to fear my child has every disease that I write about. And she had a point. But I felt like this was too serious to ignore. So, I spoke with one of our experts.

Why doctors are better than the Internet

Dr. Alison Smith, an ophthalmologist at Children’s, agreed with Meredith that the chances of Emmy having a retinoblastoma, even after having the white-eye reflex, were minute.

“Chances are the white-eye reflex is not a sign of retinoblastoma,” she said. “It’s the one everyone hears about because it’s the worst. But it isn’t nearly the most common cause for the reflex.”

Up there with the most common causes of leukocoria, she added, are bad photography angles.

Think of a pupil like a hollow tube. If someone without any eye irregularities is looking directly at the camera, her eyes will flash red because the flash illuminates straight through the tube of the pupil all the way back to the red optic nerve. On the other hand, if she is looking away from the camera, the flash will enter the tube at an angle and illuminate the white insides of the eye.

That said, determining whether a bad angle caused the white-eye reflex is difficult for an expert to do just by looking at a photo. So, it’s nearly impossible for a layman like me to do. On top of that, other possible causes like cataracts or Coat’s Disease worsen the longer they’re unidentified.

That’s why, per Dr. Smith’s advice, we took Emmy to have an eye exam at her pediatrician’s.

“I don’t think it’s overreacting at all to contact your pediatrician as soon as you notice the white-eye reflex,” she said. “Eye exams are very benign and non-invasive. They give you peace of mind and aren’t that big of a deal.”

Emmy’s pediatrician examined her eyes – as he and most pediatricians do at every checkup –and assured us that he saw no evidence of retinoblastoma, cataracts, Coat’s Disease or any of the other conditions associated with the white-eye reflex. It took about 10 minutes total. And, like Dr. Smith said, I got peace of mind.

“I guess the bottom line is that taking a picture is a good screening exam by parents but the ultimate test is having your pediatrician look at your child and then determine whether or not she needs to see a specialist,” Dr. Smith said.

So, keep taking photos of your little one. If you see a picture with the white-eye reflex, don’t assume he has cancer or cataracts like this paranoid writer did. Just take him to the pediatrician.


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19 Responses to Watch out for white eyes in photos

  1. Tricia January 8, 2015 at 2:25 pm #

    Please trust your gut if you think something is wrong. I thought I was being silly when I noticed a white glare on my 3 year old sons eyes in photos. But I asked our pediatrician about it and she immediately referred us to the eye doctor. Turns out he has an astigmatism. While not a huge medical issue by any means, catching it at this age (he most likely wouldn’t have been able to tell us on his own for years) may keep his vision from getting worse, let alone stopping the headaches he most likely would’ve endured. The doctor was so happy that I brought him in, said most people wouldn’t have noticed.

  2. Sheila December 23, 2014 at 4:46 pm #

    It happened ti my daughter. After seeing the pictures of my daughter with white reflex, I started searching about it. I didn’t find much over the web may be because i don’t know what i am looking for. I took her to her pediatrician and referred her to an opthalmologist. Doctor didn’t find anything because she was screaming the whole time. She was 19months. I went home happy and forgot all about it.
    After less than a year, i started seaching about it and learned about retinoblastoma. I went to her pediatrician and asked for a second opinion. I asked the specialist if she have cancer. He said, go to Sick Kids Hospital..They are waiting for you. So we went. Group of doctors including the head opthalmologist of the eye center was there. They started talking. Explained what the white reflex is all about. Solution is..”to remove the eyeball” to prevent the cancer spreading ti the brain. My world stopped. All i can think is how to save the eye. It cannot be saved. It hardly sees anything. No vision at all. Surgery was done 2days later.
    She was 2.5yrs old then. It was mixed emotion. It still hurts to know she lost her eye but on the other hand, she’s like any normal kid. She’s a straight A student, plays soccer whole year round. Recently tried out fir the world cup team. She didnt make it but was picked on the regional team. She has now 2 teams. She competes on all sport competition for her school.
    It’s never a bad thing to be paranoid. It can save a life.

  3. michael hubbord September 21, 2014 at 3:11 am #

    That is a very good tip especially to those fresh to the blogosphere.
    Short but very accurate information… Many thanks for sharing this one.
    A must read post!

  4. Ronna May 19, 2014 at 8:48 pm #

    I’ve took several photos with my smart phone of my 2 month old. I see the white pupils. Some photos it is one eye . Others is both. My baby had a 2 moth old well-child check-up today and I showed my pediatrician the pics on my cell phone. He examined my little ones eyes with his light. He said by shinning the light- he see’s NO white and all red which is good sign he say’s . However he is referring me to a opthomologist to be on the safe side… Well, when I got home I used my Fujifilm finepix digital camera and took several pics of my little one and NO white at all in any of my pics I take. Can a cell phone camera vs a reg digital make any difference? I am waiting for them to call for out appt to the opthomologist but in the mean-time I attend to worry after reading online about white pupils , cancer and children! Any advice on cell phones vs reg cameras?

    • Jay Mize May 22, 2014 at 4:23 pm #

      Ronna, I asked one of our Ophthalmologists your question, and he says:

      Sometimes the reflex appears white in one or both eyes, but the result of an eye exam is normal. I don’t know if this is due to the type of camera used or not. We have seen plenty of kids referred for this reason that are normal. However, since you never know the truth without an exam, it is worth getting one scheduled to make sure.

  5. jamie December 23, 2013 at 8:04 pm #

    Just an fyi to all concerned about white eye photos…., majority of pediatricians can’t really determine or diagnose anything!! They are not really trained much on this and don’t specialize in this field, that’s why there are specialists for eyes!! My nephew was just diagnosed with coats disease at 8yrs old! The only reason it was even found was because of failing a routine eye test at school and from there they started investigating the cause and come the find out it was coats disease and had been since birth and was very serious stage! A routine eye exam at a dr. office or pediatrician cannot determine or diagnose this or other things, they arent educated enough or specialized in this feild!! He had several every year and nothing until failing the eye test at school! My sister asked him how he passed previous eye exams before and he said because he cheated and would peak with his other eye because he didnt want to look stupid!!! So to every one concerned with the white eye photos like she was……please be persistant and don’t just assume that the regular dr or peditrician say its fine like they did with my nephews case for 8 yrs with them saying its nothing, he’s fine!Trust your photos and instincts, Please go to a specialist! It won’t hurt to be safe and sure because they said if it had been detected sooner,a lot more could have be done and saved him from being blind or only having partial vision!!! Who cares if they think your being paranoid!! Your a parent and that’s your job!!!!

    • M13 December 27, 2013 at 6:59 pm #

      I just went through this with my twins. My daughter right after Thanksgiving had the white eye reflex and I was on a panic about it. Her pedeatric opthomologist got me in as soon as I called and said with pictures like that it is always smart to get them checked by an opthomologist. My son had the same reflex Christmas Eve, at least this time I knew not to panic so much. Thank god the opthomologist got him in today and all is well. Not something to ignore, just because it’s probably nothing.

  6. adam boucher June 15, 2013 at 11:32 pm #

    i recently saw a photo of my 10 month old nephew on facebook, he had one red eye and the other one was white. i informed my sister of what the symptoms could be and she said it was the most supid thing she has ever heard. what should i do? please help.

    • Craig Foster June 17, 2013 at 10:02 am #

      Hey Adam,
      Good question. First, I’d let your sister know that the chances are much more in favor of it being nothing than it being caused by a disease. Second, I’d share this blog with her and cautiously advise her to have her pediatrician conduct a routine eye exam on her child.

    • Tommy August 30, 2013 at 2:04 pm #

      We saw the same thing with our little girl just after her second birthday back in March. A gorgeous photo but one eye was bright white. Took her straight to Moorfields (a specialist eye hospital in London), they saw her right away, fully examined her eyes. Thank God all was ok. The doctor explained that it was optical illusion caused by light hitting the optic nerve at the right angle to not reflect back. He also said that our little one has a blonde fundus, this means your retina has less pigment (a bit like being blonde or dark haired) and this can also contribute to seeing the white reflex. Apparently Moorfields see a few kids every month who have had a photo taken and there is the white reflex present. 99.9% of the time its nothing.
      However always be safe, forget the internet, even forget your local GP, if you see the white reflex get your child down to A&E right away and they’ll be seen.

  7. Joe May 31, 2013 at 2:41 pm #

    This happens to my whole family all the time. Me, 14, my sister, 18, and mom+dad both at 47. We’ve had no problems.

  8. Karina May 30, 2013 at 6:24 pm #

    I recently went to my prom and took several pictures with the flash on of my date and I with my iPhone, after going through them I realized my whole pupil looked white in all of them and his didn’t. I then decided to google it and I arrive here, will someone help me examine the pictures? Please email me

    • Craig Foster May 31, 2013 at 11:29 am #

      Hey Karina,
      The white eye effect is evidently common in smartphone photos. If you search for “white eyes in photos” online, there are several articles that indicate that. However, you should still go to your primary care physician/pediatrician to have your eyes examined. They can determine if anything looks suspicious with a quick, non-invasive exam.

  9. Jenn March 27, 2013 at 9:59 am #

    I recently (as in last night) became very frightened when I saw the same thing in my 3 month old (today). My boyfriend HATES when I look things up on the Internet. But then I read a post about when the child looks directly into the camera it goes away and that’s exactly what happened. I wish people would stop putting only the worse case scenarios online. The retina is the shape of an egg so if you take a picture and the person isn’t looking directly into the camera it reflects differently. I’m not saying it will always be BUT it definitely explains to me why only in pictures of her looking away I see the white (cat like) reflection. Thank you for this post!!!!

    • Craig Foster March 27, 2013 at 10:22 am #

      Thanks, Jenn. I empathize with your need to look things up on the internet. I’m happy to hear that this post might have actually helped!

  10. lenda January 9, 2013 at 11:30 pm #

    A lil nervous because my son was being video taped during Christmas nd only his eyes were all white. My other three children eyes are fine just his eyes are all white. He is 13 yrs old. So I thank you I will get him checked.

    • Nicole January 15, 2013 at 12:11 pm #

      Lenda – did you take your son to the doctor? What was the result?

  11. Craig Foster June 1, 2012 at 10:25 am #

    Thanks, Cristy. I’m trying;)

  12. Cristy Ecton May 30, 2012 at 11:37 pm #

    Craig, all this health reporting is making you very aware. That can never be a bad thing. Your daughter is lucky.

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