Pseudoleukocoria, also known as “white pupillary reflex,” is a medical term used to describe an abnormal white reflection from the pupil of the eye. Normally, when light enters the eye and reaches the retina (the light-sensitive layer at the back of the eye), it is absorbed by the retinal tissue and blood vessels, resulting in a red-orange reflex known as the “red reflex.” This is the normal appearance seen in photographs when the camera's flash captures the image of a healthy eye.
However, in cases of pseudoleukocoria, the red reflex is absent or reduced, and instead, the pupil appears white or pale in photographs. This white appearance can be caused by various underlying conditions that interfere with the normal passage of light through the eye. Some possible causes of pseudoleukocoria include:
Congenital Cataracts: Clouding of the eye's lens present at birth can block the red reflex, leading to a white appearance.
Retinoblastoma: Retinoblastoma is a rare and potentially life-threatening eye cancer that primarily affects young children. The tumor can block the red reflex, causing pseudoleukocoria. Early detection is critical for successful treatment.
Retinal Detachment: If the retina becomes detached or lifted from its normal position, it can interfere with the red reflex and result in pseudoleukocoria.
Persistent Hyperplastic Primary Vitreous (PHPV): PHPV is a congenital eye condition where a remnant of fetal blood vessels persists in the eye, causing an abnormal white reflex.
Coats' Disease: Coats' disease is a rare eye disorder characterized by abnormal retinal blood vessels that can lead to exudative retinal detachment and pseudoleukocoria.
Vitreous Opacities: Clouding or opacity in the vitreous, the gel-like substance inside the eye, can block the red reflex.
Other Eye Abnormalities: Various other eye conditions, such as persistent fetal vasculature, intraocular tumors, and ocular trauma, can also cause pseudoleukocoria.
Pseudoleukocoria is a concerning sign and should be promptly evaluated by an ophthalmologist, especially in children. It may be detected during routine eye exams or when photographs show a white pupil instead of the normal red reflex. Early diagnosis and appropriate management of the underlying cause are crucial for preserving vision and ensuring the best possible outcome for the affected individual. If you notice any unusual changes in the appearance of your or your child's eyes, seeking medical attention is important for a thorough evaluation and proper diagnosis 1).