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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Hi, My son (2 years 8 months) has a white mark in his pupil

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Hi,
My son (2 years 8 months) has a white mark in his pupil when I take a flash photo. It isn't a round white mark that seems typical of retinoblastoma but a thin moon shape on the inner edge of the pupil. He also sometimes seems to have it (but not as profound) in his other eye. Can I send a photo?
I am worried it is something serious (like retinoblastoma). Can you advise?

Doctor DanB :

Hello and thanks for your question. You may absolutely send a photo in your reply and I'd be happy to take a look at it. Thans--and I'll wait for your photo. I may be away from my desk for 5 or so minutes, but I will come back soon to check for it.

Customer:

Hi,

Customer:

Hi i am having trouble uploading the photo. It is JPEG format - is this okay?

Doctor DanB : Yes that should be just fine.
Customer:

It doesn't seem to work - I attach it and click on OK but nothing happens. Is there an alternative way of sending a photo? I have also tried PDF format.

Customer:

file://localhost/Volumes/NO%20NAME/DCIM/203PHOTO/SAM_0800.JPG

Customer:

Full Size Image

Doctor DanB :

Okay, It's loading up now...Okay.. I've seen it. Thank you for your trouble.

Doctor DanB :

This certainly does look abnormal; unfortunately it is difficult to tell just by the picture alone whether this is just a reflection or whether there is something actually wrong with the lens or the retina. For that reason...

Doctor DanB :

For that reason, I would recommend a complete, dilated eye examination with an ophthalmologist, just to be sure so any serious pathology like retinoblastoma can be ruled out.

Customer:

Full Size Image

Doctor DanB :

Does this make sense?

Customer:

It occurs in more than one photo but sometimes more in the other eye - see attached. Would bilateral retinoblastoma be a possibility at his age? Also can retinoblastoma look like this i.e., a crescent shape rather than circular?

Doctor DanB :

It is unusual for retinoblastoma to appear as a symmetric, crescent shape, but certainly not out of the realm of possibility. Also, bilateral retinoblastoma is also quite rare, but again not impossible. But it's also certainly possible that this could present bilaterally at 2 years of age, but I do not think bilateral RB presenting at age 2 is likely at all.

Customer:

Thanks. Do you have any other (more common) suggestions that it could be?

Doctor DanB :

For the most part, this intermittent crescent-type opacification that gets seen in photos occasionally is almost always just a reflection of the way light goes into and out of the eye--it can be suggestive of a need for glasses sometimes (again, another reason why the visit to the ophthalmologist's office is a good idea), but otherwise, there's nothing else common that this really could be. Make sense?

Doctor DanB :

Do you have any other concerns or questions about this topic?

Customer:

I'm just waiting for the other photo to upload so that you can see the other eye too.

Doctor DanB :

Oh, okay.

Doctor DanB :

If it helps, I've seen two of the same photos--I'm not sure whether another one is coming or not (from my end).

Customer:

Also I've been referred to see an ophthalmologist by my doctor but will probably have to wait several weeks for an appointment. Do you think I should try to be seen sooner? Also would a trip to a normal optician be able to show anything?

Customer:

The photo upload doesn't seem to be working at the moment. From the photo you have seen can you see evidence of the same thing in the other eye or is it just my imagination?

Doctor DanB :

I wouldn't bother with an optician (you'll get next to nothing out of it), but if you had the option of seeing an optometrist prior to this that wouldn't be a bad idea (most optometrists should be able to do a useful dilated eye exam to determine whether there is anything inherently wrong with the eye). I can't see anything in the right eye like what I see in the left eye from that photo.

Doctor DanB :

Do you have any other questions about this?

Customer:

No - many thanks for your help.

Doctor DanB :

My pleasure. Good luck.


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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!

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