Retinal tumor (retinoblastoma): symptoms, diagnosis and treatment
Retinal tumors in children often go unnoticed by parents. Typically, the first sign is a bright pupil in a flashlight photo. This may indicate retinoblastoma, a dangerous disease that can lead to vision loss.
In this article, we'll discuss the symptoms to look out for and how we can help you get tested.
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What symptoms should alert you?
Symptoms of a retinal tumor in children aren't always obvious, as children often can't complain. Parents notice changes in the child's eye appearance and behavior. Let's look at the main signs.
White pupil (leukocoria)
The most common sign is a white pupil, visible in photographs with a flash or under certain lighting conditions. Instead of the usual red glow, the pupil glows white or yellowish. This symptom is called leukocoria and requires a medical examination.
The glow occurs because the formation reflects the light from the flash. It's easier to notice in photographs where the pupil of one eye is clear and the other is normally red. If this effect is repeated in several photographs, it's a good reason to take your child to a specialist.
Strabismus and decreased vision
Sometimes the first sign is strabismus, when one eye deviates to the side. In older children, decreased vision in one eye may be noticed. These changes are easily attributed to fatigue, but they are also a reason to take the child to a specialist.
A young child will not complain of blurred vision. Therefore, parents notice the problem based on their behavior. The child may squint, hold toys close to their face, or lose interest in small details. Any persistent change in the child's vision deserves attention.
Redness, pain, photophobia, and enlarged eye
In later stages, redness, pain, and photophobia may appear. Sometimes the eye appears enlarged or its shape changes. These signs indicate that it's time to seek medical attention.
It's important to understand that late symptoms appear when the process is already advanced. Therefore, it's best to focus on the earliest signs, especially pupillary luminescence. The sooner the problem is detected, the greater the opportunity for careful treatment.
Why does retinal tumor develop?
The disease is based on a change in the gene that controls retinal cell growth. Sometimes this disorder is inherited, and sometimes it occurs randomly. Let's look at the main factors.
Hereditary predisposition
Some cases are associated with a hereditary form, where the altered gene is passed on from parents. In this form, the tumor most often affects both eyes. It also manifests earlier. If there is a family history of retinoblastoma, the child requires special monitoring from the first months of life.
In such cases, a genetic consultation can be helpful, as it clarifies the degree of risk. Based on the results, the doctor creates a schedule of preventive examinations. This allows for the disease to be detected at the earliest stage, when treatment options are greater.
Age characteristics and risk factors
The disease is typical for early childhood, most often before age five. It is extremely rare in adults. The main risk factor is a hereditary predisposition, so children from such families are recommended to have regular checkups.
Knowledge of family history helps identify the disease earlier. In this case, checkups are scheduled in advance, without waiting for complaints. This approach is especially important in the first years of a child's life.
How diagnostics are performed at our center
Initial ophthalmologist appointment
At the first appointment, the pediatric ophthalmologist asks the parents about any changes they've noticed and their family history. The doctor examines the eye and evaluates the pupil's response. Even at this stage, a problem can be suspected and an examination can be planned.
We try to conduct the examination calmly so the child doesn't become frightened. We explain to parents right away what will happen next and why each examination is necessary. This clear process reduces anxiety and helps save time.
Fundus examination, ophthalmoscopy, eye ultrasound
To see the retina itself, an ophthalmoscopy—an examination of the fundus—is performed. An eye ultrasound is also performed, which shows the size and structure of the lesion. These methods help understand what is happening inside the eye.
In young children, examinations are sometimes performed under sedation to examine the retina calmly and thoroughly. This is a safe and common practice. It allows for examination even of the periphery of the retina, where a lesion might be missed during a routine examination.
Orbital MRI and additional diagnostic tests
To assess the extent of the disease, an orbital MRI and, if necessary, other tests are ordered. They show whether the tumor has spread beyond the eye. This data is necessary for proper treatment planning.
MRI does not use X-rays and is therefore considered a gentle method for children. Young patients are sometimes examined under sedation to ensure the child remains still. The results help the medical team choose a safe approach.
When related specialists are involved
When the diagnosis is confirmed, a team is involved: an ophthalmologist, an oncologist, and, if necessary, a geneticist. This multidisciplinary approach helps consider all aspects of the disease. This is especially important in the hereditary form.
| Method | What it helps to identify | Why it is needed |
|---|---|---|
| Ophthalmoscopy | Retinal lesion, leukocoria | First stage of examination |
| Ultrasound of the eye | Size and structure of the lesion | Quick clarification of the picture |
| MRI of the orbits | Prevalence process | For accurate assessment and treatment planning |
General information
What treatment methods are used?
Treatment for retinal tumors is selected individually, based on the stage and extent of the disease. Modern medicine strives to preserve the eye and vision whenever possible. Let's look at the main approaches.
Organ-preserving methods
When the situation allows, organ-preserving treatments are used: chemotherapy, laser therapy, and cryotherapy. The goal is to destroy the tumor while preserving the eye. The feasibility of this approach depends on the size and location of the tumor.
The earlier treatment is started, the higher the likelihood of using gentle methods. Therefore, early diagnosis is important both for the child's health and for preserving the eye itself. Doctors decide on a specific treatment plan collectively, based on the results of all examinations.
Surgical treatment
In some cases, especially with large tumors and the risk of spreading, surgical treatment is required. The decision is made collectively, weighing the risks to the child's health. The parents are given a detailed explanation of the rationale for each chosen path.
The decision is always discussed with the oncologist and, if necessary, with other specialists. The primary focus is the child's safety and health, and eye preservation is considered where appropriate. The family is involved in the discussion and understands the reasons for the decision.
Post-Therapy Monitoring and Follow-Up
After treatment, regular follow-up is important to detect any changes early. The child undergoes routine examinations according to a schedule established by the doctor. This is part of safe patient management.
During follow-up visits, the doctor checks the condition of both eyes and the child's general well-being. In the hereditary form, monitoring is especially careful, as the process may affect the other eye. Regular check-ups help detect changes early.
In my practice, we achieve the best results when the patient presents at the first warning signs. That's why we structure our diagnostics so that people can quickly complete the examination and immediately receive a clear plan for further action. - ophthalmologist
FAQ
Short answers to questions most frequently asked by parents.
What is retinoblastoma?
What symptoms may indicate a retinal tumor?
How is the diagnosis confirmed?
Is it possible to save vision?
When might laser treatment be necessary for a child's eye tumor?
If a doctor suspects a child has an eye tumor, the examination is carried out with the utmost care, as some such lesions can be dangerous. Retinoblastoma is a malignant eye tumor, so the treatment plan is determined after a complete diagnosis.
In some cases, for small lesions on the retina, laser photocoagulation may be used. The decision is made by a pediatric ophthalmologist, taking into account the tumor's size, location, and the condition of the other eye.
Clinical Guidelines of the Ministry of Health of the Russian Federation — https://cr.minzdrav.gov.ru/
MSD Manuals, Russian version — https://www.msdmanuals.com/ru/
Russian Medical Journal — https://www.rmj.ru/
EyePress — https://eyepress.ru/
MediaSphera - https://www.mediasphera.ru/
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What is a retinal tumor and why is retinoblastoma dangerous?
The retina is the inner lining of the eye. It perceives light and transmits images to the brain. When its cells begin to grow uncontrollably, a tumor develops. Retinoblastoma is a malignant tumor of the retina, most common in young children.
The danger is that without treatment, the process spreads. The tumor threatens both the child's vision and health. However, retinoblastoma treatment is usually more effective in the early stages. Therefore, the chances of preserving the eye and vision are greater. Therefore, it's important to seek medical attention immediately.