Symptom

Leukocoria (white pupil reflex in a child)

Medical emergency in children: seek care today

Medical reviewer Mr Mohamed Mohyudin· Last recorded site review

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This page inherits the site’s previous review record. A separate, current article sign-off has not yet been recorded.

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Seek emergency assessment today if

  • A child has a white, pale or abnormal pupil reflex in one or both eyes
  • Flash photos show one red eye and one white or silvery eye
  • The white reflex is new, persistent or getting worse
  • It appears with a squint, red painful eye or change in vision

Possible causes

Several conditions can cause leukocoria. All need prompt specialist assessment in a child — do not assume it is harmless.

RetinoblastomaA rare childhood eye cancer; the most important cause to rule out urgently.CataractsA cloudy lens in a child can show a white pupil and needs specialist care.Retinal detachmentCan occur after trauma or in some inherited conditions.UveitisInflammation inside the eye may change how the pupil looks.Retinopathy of prematurityIn babies born very prematurely who had intensive neonatal care.Amblyopia (lazy eye)Not a cause of leukocoria itself, but may appear with other childhood eye problems.

What to do now

  • Contact a paediatrician or eye specialist the same day — do not wait for a routine appointment
  • Bring photos that show the white reflex if you have them
  • Do not delay because the child seems well otherwise

Frequently asked questions

Is leukocoria always retinoblastoma?

No, but retinoblastoma is the most serious cause and must be ruled out quickly. Other conditions such as childhood cataract also need urgent specialist care.

Can camera flash cause a white pupil?

Flash usually causes red-eye in both eyes. One white or silvery pupil while the other looks red, especially if repeated in several photos, is not normal and needs assessment.

What if the white reflex comes and goes?

An intermittent white reflex still needs same-day assessment. Do not wait to see if it disappears permanently.

Your next step

Take this to your appointment

Write down what has changed, when it started, your current medicines and the questions you want answered. Take these to your eye-care appointment.

Patient resourcesFind care where you live →

Sudden loss of sight, severe eye pain or a dark curtain across vision needs immediate assessment. Do not wait to complete a worksheet.

Trusted sources

For general background, these organisations provide eye-health information. This list is further reading, not a record that they reviewed this article.