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Pupil - white spots

Leukocoria

 

White spots in the pupil is a condition that causes the pupil of the eye to look white instead of black.

Considerations

 

The pupil of the human eye is normally black. In flash photographs the pupil may appear red. This is called the "red reflex" by health care providers and is normal.

Sometimes, the pupil of the eye may appear white, or the normal red reflex may appear to be white. This not a normal condition, and you need to see an eye care provider right away.

There are many different causes of white pupil or white reflex. Other conditions also can mimic white pupil. If the cornea, which is normally clear, becomes cloudy, it may look similar to a white pupil. Although the causes of a cloudy or white cornea are different from those of a white pupil or white reflex, these problems also need medical attention right away.

Cataracts may also cause the pupil to appear white.

 

Causes

 

Causes of this condition may include:

  • Coats' disease - exudative retinopathy
  • Coloboma
  • Congenital cataract (may be hereditary or may result from other conditions, including congenital rubella, galactosemia, retrolental fibroplasia)
  • Persistent primary hyperplastic vitreous
  • Retinoblastoma
  • Toxocara canis (infection caused by a parasite)
  • Uveitis

 

Home Care

 

Most causes of white pupil will cause decreased vision. This may often occur before the pupil appears to be white.

Detecting a white pupil is especially important in infants. Babies are unable to communicate to others that their vision is decreased. It is also harder to measure an infant's vision during an eye exam.

If you see a white pupil, call your health care provider right away. Well-child exams routinely screen for a white pupil in children. A child that develops a white pupil or cloudy cornea needs immediate attention, preferably from an eye specialist.

It is important to get diagnosed early if the problem is caused by retinoblastoma since this disease can be fatal.

 

When to Contact a Medical Professional

 

Contact your health care provider if you notice any color changes in the pupil or cornea of the eye.

 

What to Expect at Your Office Visit

 

The health care provider will do a physical exam and ask about your symptoms and medical history.

The physical exam will include a detailed eye examination.

The following tests may be performed:

  • Ophthalmoscopy
  • Slit-lamp exam
  • Standard eye exam
  • Visual acuity

Other tests may that be done include a head CT or MRI scan.

 

 

References

Olitsky SE, Hug D, Plummer LS, Stahl ED, et al. Examination of the eye. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 619.

Shields CL, Shields JA. Retinoblastoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3;chap 35.

Yanoff M, Cameron D. Disease of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 423.

 
  • Eye

    Eye - illustration

    The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

    Eye

    illustration

  • White spots in the pupil

    White spots in the pupil - illustration

    On occasion, the pupil of the eye may appear white. This is never a normal condition and requires immediate evaluation by an ophthalmologist. The causes of a cloudy or white cornea are different than those of a white pupil but are also significant and require immediate attention. Cataracts can also cause the pupil to appear white.

    White spots in the pupil

    illustration

  • White pupil

    White pupil - illustration

    The normal appearance of the pupil of the human eye is black. The appearance of a white pupil is never a normal condition and requires immediate evaluation by specialists trained in ophthalmology. A cloudy cornea or cataract may be mistaken for a white pupil, but usually a white pupil is due to infection or disease.

    White pupil

    illustration

    • Eye

      Eye - illustration

      The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

      Eye

      illustration

    • White spots in the pupil

      White spots in the pupil - illustration

      On occasion, the pupil of the eye may appear white. This is never a normal condition and requires immediate evaluation by an ophthalmologist. The causes of a cloudy or white cornea are different than those of a white pupil but are also significant and require immediate attention. Cataracts can also cause the pupil to appear white.

      White spots in the pupil

      illustration

    • White pupil

      White pupil - illustration

      The normal appearance of the pupil of the human eye is black. The appearance of a white pupil is never a normal condition and requires immediate evaluation by specialists trained in ophthalmology. A cloudy cornea or cataract may be mistaken for a white pupil, but usually a white pupil is due to infection or disease.

      White pupil

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Pupil - white spots

         

           

          Review Date: 11/4/2015

          Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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