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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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My grandson's eyes in photos when he was tired reflected red

Resolved Question:

My grandson's eyes in photos when he was tired reflected red eye in one and gold eye in the other. He has since been diagnosed with amblyopia and strabismus, for which he will be given glasses, patches, and vision therapy. I'm still wondering if there is any other reason for the gold reflection?
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. James replied 7 years ago.

The red eye effect from the camera is due to the light of the flash entering the eye, bouncing off the retina and blood vessels, then back into the camera. This effect is most prominent when everything is a straight line (flashes, eye, camera).

Strabismus is misalignment of the eyes. This explains why one eye had a red reflection becausee it was aligned with the camera, but the other eye had the gold reflection because it was looking somewhere else and the flash just bounced off the front surface of the eye.

Cataracts, which is a clouding of the natural lens inside your eyes, can limit the light entering and leaving the eye and may cause the gold reflection. Problems with the retina and high glasses prescriptions can also affect the reflected light, but this is unlikely in your child's case as you doctor would have easily seen it.

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Customer: replied 7 years ago.
In one photo, he is looking to the right, not directly at the camera. Still one eye is red, the other gold. Both eyes then could be said to be misaligned from the camera, so why is one red, the other gold. Have you ever seen a similar phenomenon? Can you provide a resource where this is described? I'm just trying to rule out the need for a CAT scan or MRI of the brain. His father thinks there was something wrong with my camera....
Expert:  Dr. James replied 7 years ago.
This red-eye phenomenon is very common, but not reliable to assess if the eyes are aligned. The red eye can occur in oblique positions as well, but not as common. It just means the light from the flash was able to enter the eye obliquely, then bounce back out to the camera.

There are some places that uses a camera to screen children for strabismus without access to specialists. The picture from a camera to assess strabismus can be inaccurrate. So, any questionable cases are referred to an eye doctor to confirm the strabismus. The exam by the pediatric ophthalmologist is very comprehensive. He is able to evaluate the function of the eye in real time, while the eyes are moving, and working together.

Strabismus can sometimes be due to problems with the brain, but in the majority cases there is no need for a CT scan or MRI. Unless your grandson's pediatric ophthalmologist noticed something unusual other than the strabismus, MRI is not necessary.