Newborn red reflex

[Doowai]

Can you use a penlight to check a newborns red reflex or do you have to use an ophthalmoscope?

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[DarthNeurology]

Can you use a penlight to check a newborns red reflex or do you have to use an ophthalmoscope?

I have seen a nurse practicioner, and pediatric residents too, use a penlight with the door closed, I think that the thinking is that it will be obvious if there is leukocoria, . . . however, I did see a pediatrician use an opthalmoscope to do it, and really got a good look, I would think that an opthalmoscope is better as when I do it with an opthalmoscope you can really see retina and are reassured there is no visual opacity, unlike the deer in the headlights method, which does have supposedly a fair sensitvity, but I bet not as good sensitivity as the opthalmoscope. Google Red reflex and you can see that it would hard to miss the obvious cases with the pen light method.

 

[Pastrami King]

if you are going to do it, you might as well do it right.

a true red reflex exists when the patient and the examiner's eyes are coaxial, such as with a direct ophthalmoscope. there are some conditions in which light rays exit the patients eyes in a divergent manner, such as very high hyperopia or large intraocular tumors, and a good penlight exam would pick this up.

but using the direct ophthalmoscope will be faster (assuming you have one) and you will be more confident in declaring a postitive or negative finding. and your friendly ophtho colleagues like myself will love you for it.

 

[DarthNeurology]

if you are going to do it, you might as well do it right.

a true red reflex exists when the patient and the examiner's eyes are coaxial, such as with a direct ophthalmoscope. there are some conditions in which light rays exit the patients eyes in a divergent manner, such as very high hyperopia or large intraocular tumors, and a good penlight exam would pick this up.

but using the direct ophthalmoscope will be faster (assuming you have one) and you will be more confident in declaring a postitive or negative finding. and your friendly ophtho colleagues like myself will love you for it.

Is a direct opthalmoscope the same thing as the pocket welch allyn opthalmoscope powered by simple pen light batteries and visualling blood vessels in the retina?

 

[Freibi]

Is a direct opthalmoscope the same thing as the pocket welch allyn opthalmoscope powered by simple pen light batteries and visualling blood vessels in the retina?

Yes.
http://en.wikipedia.org/wiki/Ophthalmoscope

 

[eviorr]

One thing I noticed as an intern on my nursery month last year...

The other intern and I were both complaining about how difficult it was to see a good red reflex on anyone. I was thinking about it and I realized that we both wear glasses, and sure enough, both of us had gotten the standard "anti-glare" coating on our lenses. The red reflex is really a reflection... in other words, glare. When we removed our glasses to check the RR, it became a whole lot easier.