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Symptoms and Treatment Small / Large Tumours of Retinoblastoma

Retinoblastoma is a rapidly developing cancer that develops from the immature cells of a retina, the light-detecting tissue of the eye and is the most common malignant tumor of the eye in children.

Retinoblastoma is a rare type of eye cancer that usually develops in early childhood, typically before the age of 5. This form of cancer develops in the retina, which is the specialized light-sensitive tissue at the back of the eye that detects light and color.

Retinoblastoma presents with cumulative lifetime incidence rate of 18000 to 30000 live births worldwide. A higher incidence is noted in developing countries, this has been implicated to lower socioeconomic status and the presence of human papilloma virus sequences in the retinoblastoma tissue.

Retinoblastoma is often curable when it is diagnosed early. However, if it is not treated promptly, this cancer can spread beyond the eye to other parts of the body. This advanced form of retinoblastoma can be life-threatening.

Symptoms of retinoblastoma include:
  • A pupil that appears white when light is shone into it. This may mean that a retinal tumor is present. Blood vessels in the back of the eye will normally reflect red.
  • The child's pupil does not have the normal red appearance that a flash photo creates. Instead, the pupil is white.
  • Eyes that may not move or focus in the same direction.
  • Eye pain.
  • A pupil that is constantly dilated.
  • Red eye or eyes.

Treating a small tumour that is completely inside the eye usually involves one of the following treatments:
  • Laser treatment to the eye (photocoagulation)
  • Freezing the tumour (cryotherapy)
  • Applying heat to the tumour (thermotherapy)
Larger tumours will be treated with one or a combination of the following treatments:
  • Radioactive plaque – if the tumour is not too large, a small radioactive disc is stitched over the cancerous cells and left in place for a few days to destroy the tumour, before the disc is removed.
  • Chemotherapy – usually six cycles of anti-cancer drugs are given to kill the cancer cells. Sometimes, these anti-cancer drugs are injected directly into the blood vessel supplying the eye.
  • Surgery to remove the eye – this is necessary if the tumour is large and the eye can no longer see. An artificial eye will be fitted. You can find out more information about having an artificial eye fitted on the National Artificial Eye Service website.

Pediatric Nurses