Retinoblastoma is a cancerous tumour of the eye that forms in the retina, a layer of nerve tissue in the back of the eye that senses light and sends images to the brain.
A form of childhood cancer, retinoblastoma can affect developing foetuses in the womb, as well as newborns, babies, and children up to 5 years old. It is the most common intraocular malignancy in children. If left untreated, it can pose a threat to life. Retinoblastoma can be hereditary or non hereditary, unilateral or bilateral.
Retinoblastoma is most often painless and children rarely complain of visual impairment despite its quick progression towards loss of vision in the affected eye.
Signs and symptoms of retinoblastoma
Early sign of retinoblastoma is a cloudy white pupil that might look yellow in bright light. Other symptoms may include:
Tests and diagnosis of retinoblastoma
- Poorly aligned eye
- Reddish pupil, often with pain
- Larger-than-normal pupil
- Different-coloured irises
- Poor vision or decreased vision
If your doctor suspects your child with retinoblastoma, he/she may order different tests and procedures including:
Treatment options for retinoblastoma
- Eye exam: Your eye doctor will conduct an eye exam to determine what’s causing your child's signs and symptoms. He may include certain anaesthetics to keep your child still.
- Imaging tests: Scans and other imaging tests can help your child’s eye doctor determine whether retinoblastoma has grown to affect other structures around the eye. Imaging tests may include ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI), among others.
- Consultation with other specialists: Your child's ophthalmologist may refer you to other specialists, such as a doctor who specializes in treating cancer, a counsellor or a surgeon.
The right kind of treatment for your child's retinoblastoma depends on the size and location of the tumour, whether cancer has spread to other areas, your child's overall health and your own preferences. Here are some common treatments for retinoblastoma:
- Chemotherapy: Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. It can be taken orally in a pill form or given through a blood vessel. The medicines travel throughout the body to kill cancer cells. In children, chemotherapy may help shrink a tumour.
- Radiation therapy: Radiation therapy uses high-energy beams to destroy cancer cells. Two types of radiation therapy used in treating retinoblastoma include internal radiation and external beam radiation.
- Laser therapy: During a laser therapy, a laser is used to destroy blood vessels that supply oxygen and nutrients to the tumour.
- Cryotherapy: Cryotherapy uses a very cold substance, such as liquid nitrogen to kill cancer cells.
- Thermotherapy: Thermotherapy uses extreme heat in the form of ultrasound, microwaves or lasers to kill cancer cells.
- Surgery: When all the above treatments fail to respond or when the tumour is too large to be treated, surgery may be used to treat retinoblastoma. An operation to remove the eye may help prevent the spread of cancer to other parts of the body.
Retinoblastoma has the tendency to come back. Therefore, close follow-up exams
are important for these children, who also are at risk for other types of cancer
later in life.