Thank you for your question. Are you trying to identify the two red 'dots' on the opposing leaves, or something on the leaves? Photos not too helpful. If it is the red 'dots,' it might be the rust (fungus) described here:  https://extension.oregonstate.edu/news/watch-out-rust-can-jump-incense-cedars-fruit-trees      Note:  this infects roses, as well as pear trees; both are rosaceous.

If you can send clearer photos, I can verify.  Please take photo in full light.  Thanks!

more pictures

I have not forgotten you. I have been unable to find an answer, and have asked our top plant pathologist to weigh in. He should be back in the office tomorrow.

Our pathologist believes these to be gall wasp structures: https://pnwhandbooks.org/insect/hort/landscape/hosts-pests-landscape-plants/rose-rosa-gall-wasp The article gives treatment advice. Good luck!