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Red Reflex Eye Test Recommended for Newborns


A basic eye examination, including a red reflex eye test, is recommended for all newborns, according to Angela Buffenn, MD, MPH, director of the Orbit and Eye Movement Institute at The Vision Center of Children’s Hospital Los Angeles.

The need for an eye examination that includes a red reflex eye test is especially important because of the increasing numbers of premature and medically fragile infants being born in the United States. These children often grow up with vision problems that go undetected until later in life. Conducting an eye examination and red reflex eye test shortly after birth would identify which infants may have vision problems so treatment could be initiated.

The American Academy of Pediatrics stated in its 2008 policy statement that “red reflex testing is vital for early detection of vision- and potentially life-threatening abnormalities such as cataracts, glaucoma, retinoblastoma, retinal abnormalities, systemic diseases with ocular manifestations, and high refractive errors.” The statement went on to say that the Academy “recommends red reflex assessment as a component of the eye evaluation in the neonatal period.”

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The red reflex test involves looking at the newborn’s eyes through an ophthalmoscope in a dimly lit room. The scope can detect any abnormalities in the back of the eye or white spots in the eyeball. If the results of the red reflex test are abnormal, the child should then be examined by a pediatric ophthalmologist to determine if the child has strabismus (crossed eyes), cataracts, or any of the other eye disorders mentioned in the American Academy of Pediatrics policy statement.

The American Academy of Pediatrics is joined by the American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology in recommending that an eye examination for vision assessment should be done shortly after birth. Yet studies show that about 75 percent of children younger than 5 years of age in the United States have never had a comprehensive eye examination, noted Dr. Buffenn.

An eye examination that includes the red reflex test is noninvasive and may help prevent a lifetime of vision problems. Increased awareness by both parents and medical professionals about the importance of conducting a vision evaluation at or shortly after birth is essential to identify and promptly treat those children who have visual impairments that could lead to a lifetime of disability.

American Academy of Pediatrics
Children’s Hospital Los Angeles