Retinoblastoma (Rb) is a type of eye cancer that affects young children, mainly under the age of six. It develops in the cells of the retina, the light sensitive lining of the eye. Around 40-50 cases are diagnosed in the UK every year – approximately one child a week. Retinoblastoma can either affect one both eyes.
In the UK, around 98% of children will survive but early diagnosis is really important.
This guide is going to go over the details of retinoblastoma, including the signs & symptoms and the importance of early diagnosis.
Signs & Symptoms
Retinoblastoma is a rare condition, so it is important to note that the following symptoms can be caused by other conditions, regardless it is important to get your child’s eyes checked.
• White Eye or Glow: You might see a while glow in the eye, sometimes described as a ‘cat’s eye’, a white pupil or white reflection in a photo where a flash has been used, or when your child is in artificial light or a darkish room.
• Squint: A squint, where the eyes do not look in the same direction, can sometimes be a symptom of retinoblastoma. In many cases, it’s nothing more than a squint, but all children should be checked out just in case.
• Red, Sore, or Swollen Eye: Your child’s eye may become very inflamed for no obvious reasons and with no sign of infection. This symptom is usually accompanied by one or more of the other signs described here.
• Change in Iris Colour: The iris can change colour in one eye, sometimes only in one area.
• No Red Eye: In a photo where one eye has ‘red eye’ (which is normal), the other eye may look black. This can be a sign that something is not right.
• Deterioration in Sight: Your child’s vision may begin to deteriorate, or they may have poor vision from birth. You may notice that they don’t focus, fix and follow as well as other children of the same age.
Cause
Retinoblastoma is often linked to a change in a gene that controls the growth of the eye. The change in this gene means cells in the back of the eye, retina, can grow uncontrollably. The changed gene may be passed to a child by their parents, or the gene may change as a child grows.
Unfortunately, it is not possible to prevent retinoblastoma, but screening tests can pick it up early. These tests can be carried out from birth.
Getting Diagnosed
If you’re worried that your child is showing a symptom of retinoblastoma, take them to your local optician/optometrist to have their eyes examined as soon as possible.
Test for retinoblastoma may include:
• A Red Reflex Test: A specialist will look at the back of the eye using a light.
• An Ultrasound Scan: Where a small device will be placed on the eye to take images of the inside of the eye.
• A Blood Test: To test for changes in the gene which can sometimes cause retinoblastoma.
• A Vision Test: To check your child’s eyesight.
• An MRI Scan: To check parts of the head around the eyes.
If you have any unusual photos of your child’s eye/s, take these to the optometrists with you for them to examine.
If retinoblastoma is suspected, an urgent referral will be made for your child to be seen at one of the two retinoblastoma treatment centres in the UK – The Royal London Hospital in Whitechapel, or Birmingham Children’s Hospital. An appointment will be made for your child to be seen within a week and the retinoblastoma service team will contact you, usually by telephone, before your appointment.
Treatment
Retinoblastoma can usually be successfully treated if found early. Treatment aims to get rid of the cancer but there is a high chance your child may lose some, or all, of their vision in the affected eye.
The treatment your child will have will depend on:
• The size of the cancer.
• Where the cancer is.
• If it has spread.
• Your child’s age and health.
You may be offered a combination of treatments including chemotherapy, laser treatment, cryotherapy, radiotherapy, and surgery.
Laser Treatment: Laser treatment uses a strong beam of light directed into the eye to kill cancer cells. Your child may have laser treatment for retinoblastoma if the tumour is small. Very small tumours may be successfully treated with laser therapy alone.
Cryotherapy: Cyrotherapy uses freezing to kill cancer cells. A small device is placed on the eye to freeze the cancer. Your child might have cryotherapy if the tumour is small or if the tumour is on the outer edge of the retina.
Chemotherapy: Chemotherapy is medicine that kills cancer cells. Your child might have chemotherapy to shrink the tumour before having another treatment or to treat cancer that’s in both eyes or has spread.
Radiotherapy: Radiotherapy uses radiation to kill cancer cells. It’s usually done by putting a small piece of radioactive material in the eye, or sometimes by aiming a beam of radiation at the tumour (proton beam therapy). Your child might have radiotherapy if the tumour is small, or other treatments have not worked.
Surgery: Sometimes surgery might be needed to remove the affected eye. This is called enucleation. Surgery may be needed because the cancer is spreading to other parts of the eye or other treatments have not worked. If your child’s eye is removed, it will be replaced with an artificial eye that looks and moves similar to their other eye.
Children will have regular follow-ups to check for any recurrence of the cancer and for any problems which may arise as a result of the treatment they were given.
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If you’re worried about your child’s eye health, book your child in for a comprehensive eye exam with your local D. I. Blow Opticians today.
