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Editor - Please may I suggest a re-interpretation of the pale
pupillary reflex seen in the picture in Minerva.
Normally the pupil is viewed as black unless the reflected light is
from a coaxial source such as an ophthalmoscope etc. or in this case a
Leucocoria, or white pupil, is classically due to a structure at or
near the pupil, such as a cataract, tumour etc. which can be seen lit up
with a non-coaxial source. Interestingly, these lesions may cause an
absence of the “red reflex” as they obstruct the coaxial reflection from
In my opinion, this picture may show pathology in the left eye, which
has no red reflex and therefore should be the eye undergoing urgent