Vision screening in infants and toddlers

Written by Sara Connolly, MD, FAAP, Board Certified Pediatrician

You might have noticed your pediatrician looking closely at your infant’s eyes while holding a machine like this called an ophthalmoscope.

The purpose of this is to look for a red reflex in your baby or toddler’s eye. The red reflex is the same red you sometimes see when you take a photograph and is actually a reflection of the retina of the posterior eye. If the red reflex is absent, it indicates there is something abnormal blocking the retina. There are several possible reasons for this, but the most concerning is a rare tumor called retinoblastoma.

Though rare, pediatricians are always on the alert for retinoblastoma. At each well check beginning at birth, you will notice them dim the lights and shine the light of the ophthalmascope into your child’s eyes. They will attempt to notice any asymmetry between the red reflex of the two eyes as well as any gaze difference.

While these exams are important, parents are often the first to notice a change in their child’s eye. If you notice a white spot or shadow that appears to be inside the eye, let your pediatrician know so they can check carefully. Together we can find these tumors early, which is crucial for successful treatment.

Reviewed by Dr. Sara Connolly, April 2019