What is a white pupil in photos?

What a white pupil in a photo means

In a normal flash photo the pupil glows red, because the camera light reflects off the healthy retina at the back of the eye — the familiar 'red-eye' effect. When the pupil instead looks white, pale yellow or silvery, doctors call it leukocoria. It means something inside the eye is blocking or changing that reflection. Parents usually notice it first in photos, because the flash lights up the inside of the eye. A white pupil can also sometimes be seen in dim light without a camera.

Possible causes

Several conditions can cause a white pupil reflex. All of them need specialist assessment, and one — retinoblastoma — is a cancer that must be ruled out quickly. This is why no white pupil in a child should simply be watched at home.

• Retinoblastoma — a rare childhood eye cancer; the most important cause to rule out urgently
• Congenital cataract — a cloudy lens present from birth that needs specialist care
• Coats disease — abnormal blood vessels at the back of the eye, usually affecting one eye of a young child
• Retinopathy of prematurity — retinal scarring in babies born very prematurely
• Coloboma — a gap in the eye's structure present from birth that can change how the pupil looks

Could it just be the camera?

Often, yes. Many worrying photos turn out to be harmless: on phones the flash sits very close to the lens, and at certain angles one eye can catch the light differently and look white or yellow instead of red. A photo is more likely to be a camera effect when the white glow appears in just one photo out of many, at an odd angle, while everyday photos of the same child look normal. But you cannot confirm this at home. If a white pupil appears more than once, always in the same eye, or you can see it without a camera, arrange an eye examination — and even a one-off photo is worth checking for peace of mind.

What happens at the eye examination

The examiner will ask what you have noticed and will want to see the photos that worried you, so bring them along. They will check the red reflex in both eyes and may use dilating drops to widen the pupils so the back of the eye can be seen properly. The examination is painless. If anything looks unusual, your child will be referred promptly to an eye specialist for a full assessment — that specialist assessment, not this page, is what settles the question.