Retinoblastoma

Diagnosis

The following tests may be done to detect retinoblastoma: 

• Eye exam. The doctor will perform eye exam to determine the cause of the signs and symptoms.  
• Imaging studies. To see whether retinoblastoma has spread to other structures around the eye. Magnetic resonance imaging (MRI) scan and ultrasound creates more detailed images of the eyes. 
• Spinal tap. Checks for the presence of cancer cells in the spinal fluid.
• Bone marrow biopsy. May determine if the cancer has spread into the bones and bone marrow.

Treatment 

Treatment for retinoblastoma is based on the tumor’s size, location, and if the cancer has spread to other structures of the eye. The parent’s treatment choice and the overall health of the child is also taken into consideration. 

Chemotherapy 

Chemotherapy uses medications that kill cancer cells of retinoblastoma.

• Intravenous chemotherapy.
• Intra–arterial chemotherapy. Injecting drugs into the tumor through a catheter in an artery supplying blood to the eye.  
• Chemotherapy injected directly into the eye. 

Radiation therapy

Uses high–powered energy, such as X–rays and protons to eradicate cancer cells. It can be done locally (plaque radiotherapy or brachytherapy) to treat retinoblastoma or using an external beam radiation. 

Laser therapy (transpupillary thermotherapy) 

Heat laser may be directly applied to the tumor to destroy tumor cells. 

Cold treatment (cryotherapy) 

Using a very cold substance such as liquid nitrogen to repeatedly freeze and thaw cancer cells which leaves them to die. 

Eye removal surgery 

Surgery is done if the tumor is too huge and other treatments are not helpful. It is also done to avoid the spread of cancer to other areas of the body. The following techniques may be performed: 

• Enucleation. Removes the affected eyeball including the optic nerves.
• Eye implant. Done after enucleation and replaces it with a special ball into the eye socket.
• Fitting an artificial eye. Artificial eye (usually artificially customized) may be inserted on top of the eye implant and it sits at the back of the eyelid.

Surgery may affect the other eye’s vision but the child can usually adapt. Special eyeglasses (shatter–resistant or goggles for sports) may be used for eye protection.