Retinoblastoma specialists advise parents take photos once a month to check for a normal fundal reflex in children under six years old. Photos should be taken with a digital camera (not a smartphone) in a dimly lit room, without red-eye reduction.
You can also use the CRADLE White Eye Detector app to screen a child’s eyes in real time, or to scan smartphone or tablet photo libraries for signs of leukocoria.
The PhotoRED Technique
The PhotoRED Technique was developed by an ocular oncologist (eye cancer doctor) experienced in the diagnosis and treatment of children with retinoblastoma. Research using the technique is ongoing to establish the camera’s value as a diagnostic tool.
Turn the lights down so that your camera uses the auto-flash.
Ensure any light sources – such as table lamps – are behind your child so they don’t reflect in the eyes.
Check that your camera’s red-eye reduction settings are turned OFF (refer to the instruction manual if you are not sure how to do this). The red eye reduction flash symbol is usually a diagonal line through an eye or a flash next to an eye. Make sure this is NOT showing as the flash setting.
Position yourself about four metres from your child and use the zoom to capture the child’s entire head.
Take a series of photographs from different angles – see the example below. Ask another person to help you by playing with your child while you take the photographs so their eyes don’t follow the camera.
Check each photograph carefully for abnormalities such as a white reflex, no fundal reflex, or reflexes that do not look the same in both eyes..
Variation in Colour
Fundal reflex varies in colour depending on skin and eye pigmentation. Red eye is more pronounced in light coloured eyes, and white children with very dark eyes may have no recognizable red reflex. In Asian children, the reflex appears more yellow, ranging to green-blue in African Children. Learn more about Fundal Reflex.
If you have any concerns about the appearance of your child’s eyes, request an eye exam with a specialist familiar in the examination of children’s eyes.
CRADLE White Eye Detector App
The CRADLE Mobile app scans through smartphone or tablet photos and highlights any with potential leukocoria. Screening mode uses the camera and torch to scan a child’s eyes for white reflex in real time. The app was developed by Baylor University scientists after the son of its creator (Bryan Shaw) was diagnosed with retinoblastoma.
Research shows the App correctly found leukocoria in 80% of children with diagnosed eye conditions, and on average, it detected white reflex 1.3 years before the child was diagnosed. The technology is more reliable when scanning a large library of everyday family photos, than a single photo or a small collection of posed images.
However, the app can’t yet distinguish between leukocoria caused by eye conditions like retinoblastoma, and a white glow from normal optic nerve reflex. The team of developers at Baylor University continue to train and refine app’s artificial intelligence, and aim to overcome this challenge.
Regular Eye Exams
Ensure your child’s eyes are examined with an ophthalmoscope in a darkened room at every well child visit. This simply involves shining a small light into the eyes.