Warning signs of retinoblastoma in children

Strabismus, decreased vision, eye photos taken under flash showing white instead of the usual red eyes… warn of retinoblastoma.

Retinoblastoma is the most common intraocular malignancy in children. According to the American Cancer Society, symptoms of retinoblastoma may include strabismus, one eye being a different color than the other, decreased vision, eye pain, and in some cases, the pupil does not move, and bleeding or bulging.

In many cases, the disease initially affects one eye, and over time, the other eye is also affected. Rarely, retinoblastoma develops in both eyes at the same time. Retinoblastoma almost never occurs in adults.

Common symptoms

Cat's eye reflex (leukocoria): Instead of the normal red reflex under flash conditions, when looking at the red blood vessels of the eye, a white pupil reflex is seen. This occurs in about 60% of cases of retinoblastoma. Parents can notice this in photos. When flashing a photo at night, the eyes usually appear red in the photo, but if the pupils in one or both eyes are white, the child may have retinoblastoma.

Strabismus (amblyopia): This condition causes one or both eyes to appear to turn toward the ear or nose. But sometimes strabismus is caused by other conditions other than retinoblastoma. For example, painless red and swollen eyes, decreased vision, bulging eyes, nystagmus (side-to-side movement of the eyes), congenital strabismus or bi-colored eyes, uveitis (inflammation of the middle layer of the eye).

Retinoblastoma occurs almost exclusively in children. Photo: Freepik — Retinoblastoma occurs almost exclusively in children. Photo: *Freepik*

Rare symptoms

Some children with retinoblastoma have an unusual sign called vitreous hemorrhage. This condition is a red fluid that fills the eye with blood (eye discharge). It can occur in newborns and can lead to vision loss. In some cases, blood collects between the iris and cornea. The blood covers part or all of the area, causing pain and partial or complete obstruction of vision.

In a small number of cases (less than 5%), children develop retinoblastoma in both the eye and the brain, a condition called trilateral retinoblastoma. In this condition, the brain tumor involves the pineal gland, a gland in the brain that helps regulate sleep and wake cycles. Retinoblastoma is usually limited to the eye, but in rare cases, it can spread to other areas, including the lungs, skeleton, lymphatic system, and nervous system. This can cause symptoms such as unexplained weight loss, nausea and vomiting, nerve damage, and headaches.

Retinoblastoma can cause complications such as cataracts, retinal detachment (the retina separates from the back of the eye), vision loss, bleeding, and infection. People with this cancer may also experience nausea, diarrhea, bruising, bleeding, fatigue, or the development of new cancers.

If left untreated, retinoblastoma continues to grow, and tumors can form in other parts of the eye besides the retina. This can block the drainage channels in the eye, potentially causing increased pressure in the eye leading to glaucoma. In this case, the pressure damages the optic nerve, which can cause pain and vision loss.

To protect vision and prevent retinoblastoma, parents should pay attention to any changes in the eyes and take their children to the doctor as soon as possible when they detect abnormalities. These include vision problems, abnormalities both inside and outside the eye, abnormal movement of the pupil or other eye movement problems, bulging eyes, and changes in eye color and size. About 90% of children with this tumor can be cured if detected early.

Mai Cat (According to Very Well Health )

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