The red reflex, more accurately called the fundus reflex, is when light reflecting off the inner back of your eye is visible in your pupils. In people with lighter skin, it appears red or orange. But people with darker skin can have yellow, green or bluish tints in the reflection. Abnormal coloration can be a sign of eye conditions, some serious.
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The red reflex is the normal reddish coloration of the pupils that’s visible when light shined into your pupil reflects off the inside surface of your eye. Pediatricians and other healthcare providers caring for infants, toddlers and younger children commonly look for it during regular well-child care and developmental milestone visits. And it’s a commonly visible feature in flash photography.
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Despite its name, a healthy red reflex might not always look red. Because of that, some experts recommend calling it the “fundus reflex” instead (which is how this article will mainly refer to it). That name comes from the medical term “fundus,” which is the back of your eye.
The fundus reflex happens when light enters your eye and bounces off the tissue of the fundus, the back of your eye. When it does, the reflection of that light becomes visible in the pupils of your eyes.
A key factor that influences the color of the fundus reflex is skin color, and darker skin means you might have darker tissue at the back of your eye, which can affect the color of the reflection.
That means a healthy fundus reflex may have different colors, such as:
Today, one of the easiest ways to see the fundus reflex is by taking a photo in dim surroundings and using flash illumination to make the scene brighter. Your pupils should be wider in a dimmer room to help you see better. The sudden flash for the picture will reflect off the back of your eye faster than your pupils can narrow.
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When it happens in a picture, photographers call this effect “red eye.” It’s something professional photographers generally want to avoid, and many smartphone photo apps and computer programs have special options that can remove the red effect.
The fundus reflex is an important part of well-child check-ups very early in life. That’s because it can indicate vision problems or certain eye conditions, some of them serious.
There are a few main ways that fundus reflex might appear when there’s an issue:
One thing to remember is that the fundus reflex is something trained professionals look for using special tools, like an ophthalmoscope. You can often see the fundus reflex in photos, but you shouldn’t panic if you see a difference in a single picture.
There are a few reasons for that:
If you see something about your child’s fundus reflex (or in a child you care for) that seems unusual, you might feel anxious, worried or afraid. But remember, a single photo isn’t cause for panic. There are many reasons why a picture might show an unusual difference in the fundus reflex.
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If you see the same effect repeatedly in photos, you can call your child’s healthcare provider, tell them what you’ve seen and ask them for an appointment. Your child’s provider can test your child’s fundus reflex and determine if there’s cause for concern.
This kind of test takes only minutes, usually doesn’t require eye dilation and is painless. And if your child’s provider does see something that needs further attention, they can refer you to an eye care specialist who can take a closer look.
Yes and no. There were apps previously available for this purpose, but they were mostly for research purposes. You might still be able to find one, but none have approval from any government authorities for medical use. And while new apps are coming out all the time, you shouldn’t rely on them alone.
If you ever have a question about your child’s eye health, talk to their pediatrician or other care provider. While apps might help spot causes of concern, you should never use them as a substitute for seeing a trained, qualified medical professional.
The red reflex, more accurately known as the fundus reflex, is the coloration of the pupil from light reflecting off the back inner surface of your eye. In children, testing for the fundus reflex can help catch serious eye issues, including a rare form of eye cancer.
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If you notice something unusual about the color of light reflecting in your child’s eyes (or those of a child you care for), talk to their pediatrician. A simple eye exam and test for the fundus reflex can help catch issues earlier and ease your concerns.
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Last reviewed on 11/10/2023.
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