What Does an Abnormal Red Reflex Really Mean? | Knock Knock Eye

The Glaucomfleckens November 13, 2025
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The Glaucomfleckens

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Knock knock, hi! We are Dr. and Lady Glaucomflecken. 👋 We're on a mission to inject humor and humanity into healthcare. You may know us from Dr. Glaucomflecken's videos (youtube.com/@DGlaucomflecken) or our podcast, "Knock Knock, Hi! with the Glaucomfleckens." Maybe you've even seen our live show, "Wife and Death," currently on tour! However you found us, we're thrilled that you're here.

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I’m trying something new: differentials. Each episode, I’ll pick one ocular sign and one ocular symptom, and walk you through everything that could cause them. This week: the mysterious “abnormal red reflex” and the all-too-common “my eyes are burning.” From cataracts and retinoblastoma to blepharitis and bad makeup glue, I’m breaking down the real possibilities, one red, irritated eyeball at a time. It’s part med school, part comedy, and yes, you might just become an honorary ophthalmologist by the end of it. Takeaways: Why an “abnormal red reflex” might mean anything from cataract to retinoblastoma. The simplest test pediatricians use to spot dangerous eye conditions early. How blepharitis and clogged oil glands cause that all-too-familiar burning sensation. The surprising eye problems linked to makeup, contact lenses, and preservatives. Why ophthalmologists love differentials and how this new series might just teach you to think like one. To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected] Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today’s episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. To learn more about how DAX Copilot can help improve healthcare experiences for both you and your patients visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠aka.ms/knockknockhi⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠ Chapters: 00:00 Introduction and Sponsor Message 00:49 Welcome to Knock, Knock, Hi! 00:59 New Episode Format: Ocular Signs and Symptoms 03:19 Personal Health Journey: Testosterone Replacement 05:26 Insurance Woes and Out-of-Pocket Costs 12:20 Listener Feedback and Fun Topics 15:34 Spotlight on Antimicrobial Resistance 16:38 Differential Diagnosis: Abnormal Red Reflex 21:04 Common Pediatric Eye Conditions 21:47 Understanding Retinal Detachment and Congenital Cataracts 21:59 Persistent Hyperplastic Primary Vitreous (PHPV) 23:05 Strabismus and Red Reflex Test 24:19 Other Causes of Abnormal Red Reflex 25:19 Differential Diagnosis of Ocular Symptoms 28:04 Blepharitis: The Most Common Cause of Eye Burning 30:54 Other Causes of Eye Burning 37:34 Eyelash Extensions and Eye Health 39:37 Conclusion and Final Thoughts

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