This baby has a cataract

Check the red reflexes, comparing both sides. These are often hard to see in dark-skinned babies. If the baby has a white pupillary reflex there is something seriously wrong – refer urgently.

In neonates, a clear visual axis is vital for the development of normal vision. If the baby has a cataract, the risk of long-term visual morbidity is high and the patient should be referred urgently via letter.

If the baby has already developed nystagmus, there is an urgent need for paediatric ophthalmology review.