Retinoblastoma is a cancer of early childhood, which can affect developing foetuses in the mother's womb, as well as newborns, toddlers and children up to the age of 5. A lot of parents see the first signs of retinoblastoma after noticing their child's pupil appearing whitish in bright light. Some parents might even notice this effect in photographs. This happens due to the fact that the pupil is translucent so the retinal tumours, which lie behind it, may become noticeable.
Causes
Like most other forms of cancer, in Retinoblastoma too there is a genetic aspect. Children that carry genetic mutation (from parents or grandparents) usually get more than one tumour and are more likely to develop the disease in both their eyes. It also occurs at a much younger age than children who don't have the mutation. This aspect is called hereditary retinoblastoma.
The remaining children (60%) who develop the condition have absolutely no family history of the disease and generally get it in one eye. They also have a lot less risk of developing retinoblastoma in both the eyes. This condition is called unilateral retinoblastoma.
Children with hereditary retinoblastoma in one eye can also develop it later in the other eye. This is why regular checkups of the eyes should be done every 3 months for at least 2 years. After the treatment is completed, follow-up exams should continue until the child reaches the age of 5.
Signs and Symptoms
The first sign of Retinoblastoma is a cloudy white pupil, which might also look silvery white or yellow in bright light. This is called cat's eye reflex or leukocoria. Its other symptoms include:
- Poorly aligned or wandering eye
- Reddish pupil(s), often accompanied with pain
- Pupil looking larger than normal
- Different coloured irises
- Poor vision
A lot of these symptoms are just common side effects of other eye conditions, and they do not necessarily mean that your child has retinoblastoma. If your child shows any of these symptoms, contact your doctor as soon as you can.
Diagnosis
If a child is suspected of having retinoblastoma, your doctor will refer your child to a paediatric ophthalmologist who is an eye doctor that will examine your child's retina by dilating their eye, a procedure which is sometimes under general anaesthesia. The ophthalmologist may even order imaging tests like ultrasounds of eyes, a CT scan, MRI or even blood tests.
Staging
Once a confirmed diagnosis of retinoblastoma has been made, doctors use detailed staging systems to determine the exact extent of the cancer and if it has spread to other parts of the body or not. Understanding the stage of the disease helps the doctors decide how to treat it.
Treatment
A paediatric oncologist, a paediatric ophthalmologist and a radiation therapist generally work together to treat a child suffering from retinoblastoma. This team of specialists will conceptualize a plan for every patient based on the extent of the disease within their eyes and whether it is in one or both eyes. They also try to assess whether the disease has spread beyond the eye.
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