If a white retinal reflex is seen during red reflex testing in a newborn, this finding is most commonly associated with which condition?

• A. Aniridia
• B. Coloboma
• C. Congenital cataracts
• D. Retinoblastoma

Answer: (C)

Leukocoria, a white reflex seen on red reflex testing, points to an opacity or abnormality in the eye that prevents the normal red glow from the fundus. The white reflex in newborns is most commonly due to a congenital cataract, where lens clouding blocks or scatters the red reflection, producing a white appearance. This finding is a red flag because it can also indicate serious conditions like retinoblastoma, so urgent ophthalmology evaluation is essential. While other conditions listed can alter the reflex, congenital cataracts are the most common cause of a white reflex in this setting, which is why they’re the best answer.