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.





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.
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.
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.
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 beautifulmissk@gmail.com
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.
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!!!!
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!
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.
Lenda – did you take your son to the doctor? What was the result?
Thanks, Cristy. I’m trying;)
Craig, all this health reporting is making you very aware. That can never be a bad thing. Your daughter is lucky.