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Retinoblastoma is a rare type of eye cancer that most commonly affects young children. This cancer starts in the retina or the lining of the eye and attacks the retina; generally on the back wall of the eyeball.

The symptoms of retinoblastoma begin when the baby is still in the uterus. As the baby grows, cells called retinoblasts grow out of control and form tumors. This condition is usually visible when you notice the difference in the pupils between one eye and the other.

The retina functions to send signals to the brain via your optic nerve. This process allows the eye to see and work properly. However, when a person has retinoblastoma, the retinoblast cells will continue to multiply until they turn cancerous.

Retinoblastoma can affect one or both eyes. If it affects both eyes, it can be diagnosed when the baby is a year old. Meanwhile, if it only affects one eye, the condition can usually be diagnosed at the age of 2 or 3.

If symptoms are recognized at an early age, retinoblastoma is treatable. Based on research, 90% of retinoblastoma sufferers recover successfully.

Causes of Retinoblastoma

Retinoblastoma is a cancer affecting the eye retina. The retina is a light-sensitive layer that lines the interior of the eye.

In the early stages of a baby’s development, the eye cells in the retina develop very rapidly and then stop at a certain stage. However, in some cases, one or more eye cells continue to grow and form a cancer called retinoblastoma.

In some other cases, retinoblastoma can also be caused by genetic factors and occurs when the baby is still in the uterus.

Retinoblastoma generally occurs when there is a change or mutation in one particular gene in a child’s DNA. The gene functions to control cell division. When these genes do not function properly, the cells in the retina grow out of control.

In some cases, gene damage randomly occurs in only one cell. This is what causes a tumor in one eye.

When to See a Doctor for Retinoblastoma?

The condition of retinoblastoma will first be diagnosed by a general practitioner before being referred to an ophthalmologist. The doctor will perform a red reflex test in a dark room using a magnifying device with a light on one end called an opthalmoscope.

If the child’s eye condition is normal, the doctor will see a red reflection when the light shines on the eye. However, if the reflection appears white, it is possible that the child has an eye abnormality. These disorders can include cataracts, retinal detachment, or retinoblastoma.

When the doctor suspects a certain abnormality in the child’s eye, the doctor will refer the patient to an ophthalmologist for further examinations.

The ophthalmologist will examine your child’s eyes with a red reflex test. The doctor will put eyedrops to increase the size of the child’s pupil to get a clear view of the retina at the back of the eye.

In some cases, ultrasound will be performed as an additional diagnosis. Ultrasound is an imaging device that creates sound waves to diagnose a disease, including retinoblastoma.

This procedure is a child-friendly and painless procedure. The doctor will apply gel to the outer eyelids and a small ultrasound will be placed on the eyelid.

Retinoblastoma in children can be treated through a comprehensive examination at an eye centre. The specialist doctors will be able to confirm if the cancer can be removed.

Symptoms of Retinoblastoma

In general, the symptoms of retinoblastoma may include:

  • Eyes that appear to be looking in different directions
  • Change in color of the iris, either in one or both eyes.
  • Red and inflamed eyes — usually painless 
  • Unusual white reflection in a child’s pupil. These reflections often look like a cat’s eye reflecting light and are especially visible in photos, in dark rooms, or in rooms with artificial lighting.
  • Deterioration of vision. Children will have difficulty focusing on faces or objects and controlling their eye movements. 

The symptoms mentioned above are similar to other eye conditions. To confirm the symptoms of retinoblastoma, your child is required to undergo further examinations with an ophthalmologist.

Retinoblastoma will be recognised at an early age. Usually, retinoblastoma symptoms will not appear until after your child turns 5.

In some cases, symptoms include swelling of the eyes and loss of vision.

Apart from paying attention to the physical symptoms of the eye condition, there are other symptoms to watch out for:

  • Your child keeps complaining about sore and uncomfortable eyes.
  • Your child has difficulty focusing in one direction.
  • Your child’s pupil is always open.

Treatment for Retinoblastoma

Children with retinoblastoma will be treated specifically by an ophthalmologist with sub-specialty in retinoblastoma. Although this disease is a type of cancer, you do not have to bring your child to a cancer specialist or oncologist.

However, in some cases of severe retinoblastoma, the child may need to undergo chemotherapy under the direction of a cancer specialist. Treatment for retinoblastoma will be adjusted according to the stage of the tumor:

  • Intraocular — a condition in which the cancer is completely inside the eye
  • Extraocular — an area outside the eye where cancer spreads. This area can include tissues around the eyes or other parts of the body.

Most cases of retinoblastoma are recognized at an early age. This is why it can be treated successfully before it spreads beyond the eye area.

There are two treatment options to treat small tumors in a child’s eye:

  • Laser eye treatment — can be either photocoagulation or thermotherapy.
  • Tumor ablation — performed with cryotherapy.

The objective of both treatment options is to remove and destroy the eye tumor. During the treatment, your child will be completely sedated so that they will not feel any pain or discomfort.

In some cases, the doctor may advise chemotherapy before and after the treatment. 

For larger tumors, combinations treatments can be performed, such as: 

  • Brachytherapy — a process where small radioactive plates are sewn over the tumor and left for several days to be destroyed. If the tumor has spread to the eye, brachytherapy will be combined with radiotherapy.
  • Chemotherapy — a process that involves shrinking the tumor at the start of treatment and when the cancer spreads. In some cases, chemotherapy medications are given directly to the eye.
  • Eye removal surgery — a process to treat large tumors that causes you to lose your ability to see. Once removed, you will be given an artificial eye.

Treatment Cost for Retinoblastoma

The treatment cost for retinoblastoma varies — depending on the patient’s age, treatment method chosen, and how far the cancer has spread. 

For more information regarding the estimated costs of Retinoblastoma treatment, contact Smarter Health.

Prevention of Retinoblastoma

To prevent retinoblastoma, it is necessary for your child to do routine eye examinations if: 

  • Sibling also have had retinoblastoma.
  • Family members of parents have had retinoblastoma.
  • One of the parents has a history of retinoblastoma or other eye disorders.

In addition, another preventive measure is by carrying out routine check-ups while the baby is still in fetal development. This can help detect abnormalities early on. It is recommended to continue to do regular eye tests until they turn 5. 

Some cases of retinoblastoma are caused by genetic factors. That is why you should confirm your medical history before deciding to have a baby. 

Home Remedies for Patients Diagnosed with Retinoblastoma

Retinoblastoma treatment is performed by an ophthalmologist. When the patient returns home, you need to help maintain your child’s eye health by paying attention to the eye development after treatment.

You should do this on a daily basis. If the condition gets worse, please consult your doctor immediately. 

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