Last updated 2026-02-17

The White Pupil — What It Means and Why You Should Act Quickly

The White Pupil — What It Means and Why You Should Act Quickly

What is a “white pupil”?

You’ve probably noticed that when you take a flash photo of someone, their eyes sometimes glow red. That red glow — sometimes annoying in photos — is actually a sign of healthy eyes. It happens because the flash bounces off the back of the eye, where there’s a layer of tissue full of tiny blood vessels. This layer is called the retina — think of it as the “screen” inside the eye that receives images, like the film in a camera.

But sometimes, instead of red, a child’s pupil — the black circle in the center of the eye — looks white, grayish, or yellowish in photos or under certain lighting. Doctors call this leukocoria (loo-koh-KOR-ee-ah), which simply means “white pupil” in Greek. You might notice it as a bright white spot in one eye while the other eye looks normal and red. [Source: src1]

If you ever notice this — in a photo, or when light catches your child’s eyes at a certain angle — please take it seriously. It doesn’t show up every time, and it doesn’t automatically mean something terrible is happening. But it does mean your child needs to be examined by an eye doctor as soon as possible. [Source: src6]

Why does it happen?

A white pupil means something inside the eye is blocking the normal red reflection. Think of it like shining a flashlight into a dark room — if someone hung a white curtain inside, you’d see white reflected back instead of the dark room behind it. Several things can cause this “curtain” effect inside a child’s eye. [Source: src1]

The most common cause: childhood cataract

When most people hear “cataract,” they think of elderly grandparents. But babies can be born with cataracts too, or develop them in early childhood. A cataract is when the lens of the eye — a small, normally clear disc that sits behind the pupil and helps focus light — becomes cloudy or opaque, like frosted glass.

In studies of children who showed up at the eye doctor with a white pupil, about 60% turned out to have cataracts. [Source: src2]

The important thing about childhood cataracts is that timing of treatment is critical. For the best chance of normal vision, cataracts in one eye should ideally be removed surgically by around six weeks of age, and cataracts in both eyes by eight to ten weeks. If surgery is delayed too long, the brain never learns to “see” properly through that eye — a kind of permanent vision loss called deprivational amblyopia (am-blee-OH-pee-ah), commonly known as “lazy eye.” [Source: src4]

The most serious cause: retinoblastoma (eye cancer)

This is the one that understandably frightens parents the most. Retinoblastoma (reh-tin-oh-blas-TOH-mah) is a cancer that grows in the retina — that “screen” at the back of the eye. In the same studies, about 18% of children with a white pupil had retinoblastoma. [Source: src2]

Some key facts that may help put this in perspective:

• It’s rare — it occurs in roughly 1 in 15,000 to 1 in 30,000 births. [Source: src3]
• It mostly affects very young children — the majority are diagnosed before age 2, and less than 5% of cases occur after age 5. [Source: src8]
• A white pupil is its most recognizable sign, appearing in 60% to 80% of cases. [Source: src3]
• When caught early, survival rates are very high in places with good medical access. [Source: src3]
• But if diagnosis is delayed, treatment becomes much harder, and outcomes get significantly worse. Early detection can mean the difference between saving the eye and losing it — or even between life and death. [Source: src3]

About 45% of retinoblastoma cases are hereditary (passed down in families), so if anyone in your family has had this condition, your child should be monitored closely from birth. [Source: src3]

Other possible causes

A white pupil can also be caused by several less common conditions, including:

• Persistent fetal vasculature — blood vessels inside the eye that were supposed to disappear before birth didn’t go away (about 4% of cases) [Source: src2]
• Coats disease — abnormal growth of blood vessels in the retina, which may cause a yellowish rather than white reflection (about 4% of cases) [Source: src2]
• Retinopathy of prematurity (ROP) — a condition that affects babies born very early (before about 30 weeks of pregnancy), where the blood vessels in the retina develop abnormally [Source: src1]
• Retinal detachment — where the retina peels away from the back of the eye (about 3–4% of cases) [Source: src2]

The color of the reflection can sometimes give doctors a clue: a true white glow often points toward retinoblastoma or cataract, a blue-gray tint is more typical of cataracts, and a yellowish glow may suggest Coats disease or retinal detachment. But only a proper examination can determine the actual cause. [Source: src1]

Every one of these conditions either threatens your child’s vision or — in the case of retinoblastoma — their life. That is why any white pupil in a child needs urgent evaluation. [Source: src1]

The flash photo check — something you can do at home

One of the simplest things you can do as a parent is pay attention to your child’s eyes in photographs taken with flash. This isn’t a medical test, and it can’t replace a professional examination — but it has genuinely helped many families catch problems early. Here’s what to do:

1. Take a photo with flash on in a room that’s not too bright (dimmer light causes the pupil to open wider, making any abnormality easier to spot).
2. Look at both eyes. They should both show the same color — usually red or orange.
3. Watch for differences between the two eyes. If one eye looks red and the other looks white, yellowish, or just “different,” that’s worth getting checked.
4. Don’t rely on just one photo. A white reflex doesn’t show up every time — it depends on the angle of the light and where your child is looking. But if you see it even once, take it seriously. [Source: src6]

One important caution about modern phones: Many smartphone cameras have a “red-eye removal” feature that automatically corrects the red glow in photos. Unfortunately, this feature may also remove a white glow — the very thing that could alert you to a problem. If you’re checking on purpose, try turning off red-eye correction in your camera settings, or use a standalone camera with flash. [Source: src6]

In hospitals and clinics, doctors do a more thorough version of this check using a special handheld light called an ophthalmoscope (off-THAL-moh-scope). This is called the red reflex test, and it’s part of routine newborn and well-baby checkups in many places, including the US (recommended by the AAO), the UK (part of NHS newborn screening), Japan (part of the 1-month and infant health checkups), and Singapore (where the Health Promotion Board’s School Health Service provides vision screening from Kindergarten 1 onward as part of the National Myopia Prevention Programme). [Sources: src7, src9, src10, src12]

What should you do if you notice a white pupil?

See an eye doctor as soon as possible — within days, not weeks.

Don’t wait for your next scheduled checkup. Call your child’s pediatrician or go directly to an eye doctor (ophthalmologist) and tell them what you saw. If you have the photo that worried you, bring it along — it can be genuinely helpful. [Source: src3]

Your child will likely need a dilated eye exam — the doctor puts special drops in the eyes to make the pupils open wide, which lets them see the structures inside clearly. This might sound uncomfortable, but it’s painless and the effects of the drops (blurry close-up vision and sensitivity to light) wear off within a few hours. Depending on what the doctor finds, they may also use an ultrasound or other imaging to look inside the eye in more detail. [Sources: src1, src3]

Here’s what’s reassuring: not every white pupil turns out to be something serious. Sometimes it really is just the angle of a photo, or light reflecting off the optic nerve in a particular direction. But there is no way to know this without a proper examination. And the conditions that do cause a true white pupil are all time-sensitive — earlier detection means better outcomes, more treatment options, and better chances of preserving your child’s vision. [Source: src3]

Key takeaways for parents

• A healthy eye reflects red in flash photos. A white, gray, or yellow reflection in the pupil — called leukocoria — needs prompt attention from an eye doctor.
• The most common cause is a childhood cataract (clouding of the lens inside the eye). It’s treatable with surgery, but timing matters enormously — the sooner, the better.
• The most serious cause is retinoblastoma (a rare eye cancer in young children). It has very high survival rates when caught early, but delayed diagnosis makes everything harder.
• Check your child’s flash photos from time to time. Compare both eyes. Turn off red-eye removal when checking.
• If you see a white pupil even once — don’t panic, but do act. See an eye doctor within days.
• Make sure your child gets routine red reflex screening at birth and during infant checkups. This test exists specifically to catch these conditions early.

⚕️ Medical Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you notice a white pupil or any other unusual appearance in your child’s eyes, please seek evaluation from a qualified eye care professional as soon as possible.

Sources

1. Kanukollu VM, Tripathy K. “Leukocoria.” StatPearls, NCBI Bookshelf, 2023. https://www.ncbi.nlm.nih.gov/books/NBK560794/
2. Haider S, Qureshi W, Ali A. “Leukocoria in Children.” Journal of Pediatric Ophthalmology and Strabismus, 45(3):179-80, 2008.
3. Fabian ID, Abdallah E, Gombos DS, et al. “Retinoblastoma.” StatPearls, NCBI Bookshelf, 2025. https://www.ncbi.nlm.nih.gov/books/NBK545276/
4. Khokhar SK, et al. “Pediatric Cataract.” StatPearls, NCBI Bookshelf, 2025. https://www.ncbi.nlm.nih.gov/books/NBK572080/
5. Youngstein K. The Eye Book: An Illustrated Guide for Patients. Cybersight / Orbis International, 2017.
6. American Academy of Ophthalmology. “A Stepwise Approach to Leukocoria.” EyeNet Magazine, 2017.
7. American Academy of Ophthalmology. “Pediatric Eye Evaluations Preferred Practice Pattern.” Ophthalmology, 2023.
8. Merck & Co. “Retinoblastoma.” Merck Manual Professional Edition, 2024.
9. NHS (UK). “Eye tests for children.” 2024. https://www.nhs.uk/tests-and-treatments/eye-tests-in-children/
10. 日本弱視斜視学会. “3歳児健康診査における視覚検査について.” 2023. https://www.jasa-web.jp/general/about-3sai
11. 衛生福利部國民健康署. “兒童視力篩檢及矯治指引.” 2020. https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=609&pid=1077