Female carriers of X-linked recessive eye diseases may show variable expression of the disorders depending on the timing of X-inactivation. Patients with late X-inactivation have widely dispersed affected cells intermixed with unaffected cells, sometimes producing a characteristic tapetal reflex or "metallic sheen" as seen in this photograph. This patient is an asymptomatic carrier of X-linked retinitis pigmentosa who has two affected sons.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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