I've noticed that a friend of mine (age 40) has leukocoria in both eyes?

It might be a serious problem, or it just could be as simple as early-onset cataracts (which can have a leukocoria apperance).

Your best bet is to mention your observation to your friend. If he already knows about it and has had it checked out, great! It will put your mind at ease. But if he is not aware of it, he should make an eye appointment with an OPTOMETRIST (not an ophthalmologist ... you usually need a referal from an optometrist to see an ophthalmologist for a specific reason). They will be able to do a full health examination to see what may be causing the leukocoria. If there is a problem, they will then be able to refer him to the proper specialist (not all ophthalmologists deal with the same thing) to have it taken care of.

In infants, one of the most well-known and most serious causes of leukocoria is a retinoblastoma (a tumor). So although it would be odd to have tumors in both of your friend's eyes causing this leukocoria, it is definitely one of the worst-case-scenarios that has to be ruled out.

Like I mentioned earlier, it could be something as relatively harmless as a media opacity like a cataract that do develop with age and will decrease the bright red reflex that you see in younger adults.

How exactly have you noticed this leukocoria? In photographs?

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Leukocoria is a white reflection from the retina of the eye, resembling eye shine. It is a medical sign of a number of sight and possibly life threatening eye conditions and generally does not occur in both eyes. Leukocoria can also resemble an advanced stage cataract, but then your friend would have severe vision problems. Are you quite sure that the shine you might be noticing in his eyes is not an intermittent reflection from lighting, eye glasses or contact lenses? Leukocoria is a very serious eye disease which is quite noticeable, expecially in the later stage, and your friend would have realized he had a problem long ago. His pupil would be white or opaque and his vision would be severely impaired. If you are truly concerned, why not suggest that the two of you make an appointment with an ophthalmologist for a comprehensive dilated eye exam. (A dilated exam allows the eye doc to examine the back of the eye (retina etc.) Just express the idea as preventative eye maintenance. Most of us don't see an Ophthalmologist or Optometrist until we have a real problem, which might have been prevented or minimized if we had regular eye exams.

Leukocoria is an indicator of a serious problem. If it developed over time, your friend may not have noticed his gradual decline in vision. You would be doing him a favor by mentioning that something looks unusual in his eyes. You'll know by his response if it's something he's already aware of. If he hasn't been aware of it, tell him he needs to see an opthamologist as soon as possible. The sooner an eye problem is corrected, the less chance there is for complete vision loss.

Mineage Ip

Don't know anything about how serious this is; but as a friend you should voice your concern. My mother noticed something about my son when he was only two that I did not think was a big issue and required immediate surgery. I would think if you care about him you would voice your concern. Best wishes.