“Her eye turns in sometimes — and in photos one eye looks white, not red. People say she’ll grow out of it”

In a young child, a WHITE reflex (LEUKOCORIA) — including one a parent notices in flash PHOTOGRAPHS — or an ABSENT/abnormal RED REFLEX on examination is a serious RED FLAG that can indicate RETINOBLASTOMA (a malignant eye tumour of early childhood), as well as congenital cataract or other pathology, and must never be dismissed as "she’ll grow out of it". NICE NG12 (children and young people) advises considering a suspected cancer pathway referral to ophthalmology for retinoblastoma in a child with an absent fundal (red) reflex, and NICE NG127 advises immediate referral (seen within hours) for a new-onset squint with loss of the red reflex, so examine the red reflex in both eyes face to face the same day (compare for an absent, white or asymmetric reflex — not possible on video), ask to see the photographs the parent describes, and make that urgent referral — a credible parental report of leukocoria warrants referral even if the in-clinic reflex looks equivocal. Separately, assess the SQUINT (strabismus): intermittent squint in the first ~3 months of life can be normal, but a constant squint, any squint after about 3 months of age, a squint with reduced vision, or any concern needs orthoptic/ophthalmology referral, because untreated squint risks AMBLYOPIA ("lazy eye") and permanent vision loss if not treated early — so "they’ll grow out of it" is not a safe blanket reassurance. Refer and act without delay (NICE NG12 (Suspected cancer: recognition and referral, last updated April 2026) suspected cancer pathway referral for the leukocoria/retinoblastoma, or immediate referral under NICE NG127 for a new squint with loss of the red reflex, plus orthoptic/paediatric ophthalmology for the squint), and communicate by validating the parent’s instinct, explaining honestly why urgent assessment is needed without inducing panic, acknowledging that most squints are benign while the white reflex specifically needs prompt checking, and supporting an anxious parent — avoiding both false reassurance and catastrophic language.