What is the appropriate next step for a 2-year-old female with a white reflex in her right eye?

In a 2-year-old female presenting with a white reflex (leukocoria) in one eye, the most appropriate next step is to refer her to an ophthalmologist. A white reflex can indicate several significant ocular conditions, the most concerning of which is retinoblastoma, a malignant tumor of the retina that is most common in young children. Other potential causes of leukocoria can include cataracts, retinal detachment, and persistent fetal vasculature, among others.

An ophthalmologist specializes in diagnosing and treating eye conditions, and immediate evaluation is critical to determine the underlying cause of the leukocoria. This swift referral can lead to a timely diagnosis and management plan, which is vital given the seriousness of potential conditions like retinoblastoma.

In contrast, observation is not appropriate in this scenario, as leukocoria requires a thorough examination to rule out life-threatening issues. A referral to a pediatrician might be beneficial for overall health monitoring or additional concerns but does not directly address the urgent need for specialized evaluation. Immediate surgery is not justified without a confirmed diagnosis, as appropriate surgical intervention would depend on the specific condition diagnosed by the ophthalmologist.