Retinoblastoma is a tumor of the light-sensitive retina at the back of the eye and usually occurs in young children under the age of 3.
When parents take pictures with a flash, they may notice that something is wrong, and instead of the pupils of one or both eyes of the child appearing to be red in the photo, they appear to be white or pink.
Other symptoms include eye pain and vision problems, lazy eye and pupil problems, and in some cases bleeding or swelling. Even the shadows of the colored parts of the eyes may be affected. As many as nine out of ten children have the potential to be cured of this type of tumor.
In about two-thirds of cases, only one eye is affected. However, the other eye may be affected later. But in rare cases, retinoblastomas develop in both eyes.
This article will discuss common and rare signs and symptoms that can help you find this rare eye tumor early. It will also cover complications of retinoblastoma and when to see a doctor.
There are countless possible retinoblastoma signs that could indicate this condition. Some of the most common signs include:
- Cat’s Eye Reflex (White Eye Reflex): In flash conditions, when you see the red blood vessels of the eye, you will notice the white pupil reflex instead of the normal red reflex. This occurs in about 60% of retinoblastoma cases. It doesn’t always indicate retinoblastoma, it just should be ruled out by an ophthalmologist (ophthalmologist).
- crossed eyes (squint) or lazy eyes (amblyopia), one of the eyes appears to be looking at the ear or nose: These conditions are usually caused by something other than retinoblastoma.
- Inflamed red eye, usually without pain
- vision loss
- left-right movement of the eye, called nystagmus
- Left and right pupils are different in size
- Different eye colors in the same person (heterochromia)
- Uveitis: This is inflammation of the middle layer of the eye
Some children with retinoblastoma may also show other unusual signs. Some babies may experience what’s called a vitreous hemorrhage, where blood leaks near the gel-like fluid (vitreous) that fills the eye. This can lead to vision loss.
In some cases, there’s also a so-called “hyphema,” in which blood collects between the colored iris and the clear, dome-like covering called the cornea. Not only is this painful, but it can lead to partial or complete vision blockage due to blood covering some or all of the area.
In less than 5% of cases, children develop retinoblastoma not only in the eye but also in the brain, called trilateral retinoblastoma. In most cases, brain tumors involve the pineal gland, which is located in the brain and helps regulate sleep and wake cycles.
While in most cases, retinoblastoma is confined to the eye, in rare cases it can spread to other areas, including the lungs, bones, lymphatic system, and nervous system. This can cause the following symptoms:
- Weight loss for no apparent reason
- feel sick and vomit
- nervous system damage
In addition to being alert for potential signs of retinoblastoma, it’s important to understand treatments and how they can help and what to do if the tumor spreads.
There are a variety of complications associated with retinoblastoma treatment that are of concern. These include:
- Radiation therapy may form cataracts, in which the lens becomes cloudy. However, the lens can then be removed and vision restored. Cataract removal also does not seem to stimulate new retinoblastoma formation.
- Retinal detachment (detachment of the retina from the back of the eye)
- loss of vision
- Infection or bleeding from surgery
- Chemotherapy reactions such as nausea, diarrhea, bruising, bleeding, and tiredness
- The spread of retinoblastoma
- new cancer
If retinoblastoma continues to grow, the tumor may form in other parts of the eye other than the retina. These block the drainage channels in the eye, which can lead to increased intraocular pressure. This can lead to glaucoma, where pressure damages the optic nerve, causing vision loss and pain.
Adult retinoblastoma almost never occurs. Only about 30 cases have been recorded worldwide. These extremely rare cases have been reported in people between the ages of 20 and 74. Symptoms found in this group include:
- loss of vision, partial or complete
- white lump
When to see a healthcare provider
One of the keys to preserving vision in retinoblastoma is catching it early. Please note the following:
- any changes in vision
- anything that looks different to the eye, both inside and out
- any differences in the way the eyes move
If you notice any slight abnormality in your child’s vision or the appearance of the eyes, have them checked by a healthcare provider right away.
Retinoblastoma cases can occur in children and are often noticed by parents who are vigilant about signs and symptoms. The first signs can be detected in photos taken with the flash, which will show white flashes instead of the typical red-eye appearance.
Wayward lazy eye may also indicate retinoblastoma, although it may be the result of muscle weakness. Report any vision changes, movement problems, bulging eyes, or changes in eye color or pupil size to your doctor.
Watching out for signs of retinoblastoma may protect your child’s vision. Although this tumor is uncommon, and any symptoms can be due to less serious causes, if your child does have retinoblastoma, treating it as soon as possible can greatly improve your child’s prognosis.