Noticing a white eye, white pupil or white reflection in a photo or in the eye doesn't always mean your child has retinoblastoma (Rb). There are several different conditions that could cause this or the white eye reflection may be completely harmless, but we always recommend that if you do spot anything unusual you have it checked out as soon as possible, to rule out anything more serious.
The medical term for this white eye reflex or reflection is 'leukocoria' – leukos means white and kore means pupil. In humans it occurs when there is an abnormal light reflection in the eye. It will show up most often in photos, or in low light levels.
Below is a list of the conditions that may result in the white eye reflex, but an eye professional will be able to do the proper tests on your child to ascertain if there is any cause for concern. If you do notice anything unusual about your child's eyes or notice anything unusual in a photo, the most important thing is to have their eyes checked quickly (visit our Who to See page).
Possible conditions resulting in leukocoria or white eye/pupil in a photo:
Light shining off the optic nerve: this is the most common cause of a white reflex or white pupil in a photo
- Light entering the eye at a certain angle may be reflected from the optic nerve. It becomes magnified and the white eye effect may be seen.
Cataract: if it is not due to the optic nerve becoming magnified (in a photograph), it is most likely to be due to this condition.
- A clouding that develops in the lens of the eye, which may show up as the white eye effect in a photo. Surgery can treat this condition.
P ersistent H yperplastic P rimary V itreous
- The vitreous is the jelly like substance inside the eye. This condition is due to an embryological disorder and results in a cataract (above) or a scarred retina (film of the eye).
Vitreous haemorrhage (Rhegmatogenous RD)
- Small amounts of blood leak into the jelly in the eye, possibly from a tiny tear in the retina, preventing much of the light passing through to the retina and potentially causing white eye.
- A tumour develops on the retina at the back of the eye. Light (sometimes from a camera flash) bounces off the tumour, sometimes making the pupil look white in low light or photos. See our page Signs and symptoms.
- Is a rare, benign tumour of the retina and can be associated with a condition that also affects the skin called tuberous sclerosis. White eye can be caused in a similar way to retinoblastoma.
ROP (Retinopathy of prematurity)
- Disorganised blood vessel growth in premature babies causing a scarred retina.
- While still in the womb, the retina in the eye does not develop properly, or later on there may be changes to the blood vessels in the eye.
- Parasitic infection causing damage to the retina.
- Tumour of an area of the eye, which is rare.
- If the eyes are not properly aligned they do not gaze in the same direction (also known as a squint). At a certain angle light will be reflected back out of the eye from the optic nerve, resulting in the white eye effect. Sometimes an absent reflex is seen.
Please remember that retinoblastoma is rare, with just 40 -50 new cases diagnosed in the UK each year. However, we always recommend you get your child's eyes checked out as soon as possible if you notice any of the signs and symptoms, if only to rule out a serious eye condition.
The Childhood Eye Cancer Trust has published an awareness-raising leaflet with all the signs and symptoms displayed on it. You can download a copy of that leaflet here.
Examine these images to see the different ways in which retinoblastoma can present itself.
Advice on who to turn to if you think you have noticed the signs or symptoms of retinoblastoma in a child’s eye(s).
A brief account of what will happen next if your child is referred for further examination.