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Absent red reflex — DRCOG MCQ

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EasyPostnatalAbsent red reflexDRCOG

A 2-week-old baby is seen for feeding advice. On examination, the red reflex is absent in the right eye. The baby is otherwise well and afebrile. When should this patient be referred?

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Correct answer: A — Refer urgently to ophthalmology

An absent or asymmetric red reflex can indicate cataract, retinoblastoma or other serious pathology and requires urgent ophthalmology referral. Waiting until the 6-week check risks delayed diagnosis. Antibiotic drops do not address an absent red reflex. Routine optician review is not appropriate for a newborn with this finding.

Reference: NHS NIPE screening programme; NICE NG194