Pupil - white spots

• Illustrations
• Alternative names
• Definition
• Considerations

• Common Causes
• Home Care
• Call your health care provider if
• What to expect at your health care provider's office

Alternative names    Return to top

Definition    Return to top

In this condition, the pupil of the eye, which is normally black, appears white.

Considerations    Return to top

The normal appearance of the pupil of the human eye is black. In flash photographs the pupil may appear red. This is known to photographers as redeye and to physicians as the red reflex -- it is entirely normal.

On occasion, the pupil of the eye may appear white. This is never a normal condition and requires immediate evaluation by trained specialists (ophthalmologists, "eye doctors," not optometrists who can only prescribe lenses or glasses).

There are many different causes for white pupil, which are described below. Other conditions can also mimic white pupil. For example a cloudy cornea (usually, the clear part of the eye) may produce an appearance similar to a white pupil.

The causes of a cloudy or white cornea are different from those of a white pupil, but are also significant and require immediate attention. Cataracts may also cause the pupil to appear white.

Common Causes    Return to top

• retinoblastoma
• congenital cataract - may be hereditary or may result from other conditions, including congenital rubella, galactosemia, retrolental fibroplasia (retinopathy of prematurity)
• intraocular infections - infections within the eyes)
• persistent primary hyperplastic vitreous
• Coats' disease - exudative retinopathy)

Home Care    Return to top

If a white pupil is noted, an immediate appointment with your health care provider should be made. Pediatricians routinely screen for the appearance of a white pupil in children. If a child develops a white pupil or cloudy cornea, immediate attention is required, preferably from an ophthalmologist.

Call your health care provider if    Return to top

• you note any discoloration of the pupil or cornea of the eye.

What to expect at your health care provider's office    Return to top

The medical history will be obtained and a physical examination performed.

Medical history questions documenting white spots in the pupil may include:

• When did you first notice this?
• Are both eyes affected?
• Is there any change in the vision, including a decrease in vision, blurred vision, or others?
• What other symptoms are also present?
• Is there a family history of disease, such as congenital cataracts or retinoblastoma, both of which tend to be hereditary?
• Are the eyes crossing?
• Any recent eye surgery?

The physical examination will include a detailed eye examination.

Diagnostic tests may include:

• slit-lamp exam
• standard eye exam
• visual acuity
• ophthalmoscopy
• other tests depending on the suspected cause, including a head CT or MRI

AFTER SEEING YOUR HEALTH CARE PROVIDER

If a diagnosis was made by your health care provider as the cause of white spots in the pupils, you may want to note that diagnosis in your personal medical record.