Retinoblastoma

What it is

Retinoblastoma is a tumour that develops in the light-sensitive retina at the back of the eye. It almost always affects children, usually before age five. It can occur in one or both eyes and may be inherited or appear without a family history. Because the eye is small and symptoms can be subtle, parents and clinicians must take warning signs seriously.

Warning signs

Some signs are easy to miss. Seek urgent paediatric or eye specialist advice if you notice:

• A white pupil reflex (leukocoria) in flash photos or in dim light — sometimes described as a 'cat's eye' glow
• A new squint or the eyes not lining up
• Redness, swelling or pain that does not settle
• A change in vision or the child not tracking objects as before
• A difference in pupil size or colour between the eyes

Diagnosis and treatment

Specialists examine the eyes under anaesthetic, use imaging such as ultrasound or MRI, and may arrange genetic testing. Treatment depends on tumour size and whether one or both eyes are affected. Options can include laser therapy, chemotherapy, radiotherapy, or in some cases removal of the eye to protect the child's life. Lifelong follow-up is usually needed.

Support for families

A retinoblastoma diagnosis is frightening, but outcomes have improved greatly with modern care. Teams include paediatric oncologists, ophthalmologists and support workers. Ask about vision rehabilitation, prosthetic eyes if needed, and genetic counselling when a family history exists. Do not delay assessment because you hope a white reflex will go away on its own.