Red Reflex Examination in Infants. AAP Section on Ophthalmology. PEDIATRICS (May 2002); 109:980-1.

Red reflex examination is recommended for all infants. This statement describes the indications for and the technique to perform this examination, including indications for dilation of the pupils before examination and indications for referral to an ophthalmologist.

Excerpts:

• Concern has been expressed recently that diagnosis of serious ocular conditions, including retinoblastoma and congenital cataract, in which early treatment is essential for future ocular and systemic health, often is not made sufficiently early to minimize potential consequences of those conditions. This concern has led to consideration of legislation in several states mandating early pupil-dilated red reflex examinations in all neonates or very young infants.

• Significant complications have been sporadically reported with all commercially available dilating agents, including sympathomimetic agents like phenylephrine and anticholinergic agents like cyclopentolate hydrochloride and tropicamide. These complications include elevated blood pressure and heart rate, urticaria, cardiac arrhythmias, and contact dermatitis.

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