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Pupil - white spots
Definition
White spots in the pupil is a condition that causes the pupil of the eye to look white instead of black.
Alternative Names
Leukocoria
Considerations
The pupil of the human eye is normally black. In flash photographs the pupil may appear red, an effect called "red eye." This is also called the "red reflex" by health care providers, and is entirely normal.
On occasion, the pupil of the eye may appear white. This is never a normal condition and needs to be seen right away by an eye care provider.
There are many different causes of white pupil. Other conditions also can mimic white pupil. A cloudy cornea (usually, the clear part of the eye) may look similar to a white pupil. The causes of a cloudy or white cornea are different from those of a white pupil, but are also significant and need immediate attention.
Cataracts may also cause the pupil to appear white.
Causes
- 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
If you see a white pupil, make an appointment with your health care provider right away. Well-child exams routinely screen for a white pupil in children. If a child develops a white pupil or cloudy cornea, immediate attention is needed, preferably from an ophthalmologist.
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 perform a physical exam and ask questions, such as:
- When did you first notice this problem?
- Are both eyes affected?
- Is there any change in the vision, including a decrease in vision, blurred vision, or other vision problems?
- What other symptoms do you have?
- Is there a family history of disease such as congenital cataracts or retinoblastoma?
- Are the eyes crossing?
- Have you had any recent eye surgery?
The physical examination will include a detailed eye examination.
The following tests may be performed:
Other tests may be done, depending on the suspected cause, including a head CT or MRI scan.
References
Yanoff M, Cameron D.Disease of the visual system. In: Goldman L, Ausiello D, eds.Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 431.
Olitsky SE, Hug D, Plummer LS, Stass-Isern M. Examination of the eye. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 611.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
