In infants, the following is a serious examination finding:
A. Lack of red reflex
B. Eyelid telangiectasia
C. Delayed pupillary reaction
D. A and C
ANS: D
Red Flags for the Eye Examination
• Presence of white instead of red reflex may indicate retinoblastoma; an absent red reflex or opacity of the lens may indicate cataracts
• Dilated and fixed pupils, which indicate severe brain damage
• Strabismus, which requires referral to ophthalmology for further evaluation
Some variations that may be noted in newborns include the presence of "stork bites" (telangiectatic nevi) on the eyelids, nasolabial area, or nape of the neck; they appear as a purplish-red color and generally diminish and/or disappear by 12 months of age.
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