What are the symptoms of Retinoblastoma

• The appearance of a white hue at the centre of the eye; particularly upon light shining onto the eye.
• Swelling of the eye
• Reduced visual acuity
• Redness in the eyeball
• Eyes that give off the impression of viewing different directions

What causes of Retinoblastoma

When nerve cells in the retina begin to mutate in an atypical manner, it can cause these cells to replicate themselves and multiply beyond a point that normal cells would normally expire. The resulting excess clump of cells manifests itself as a tumour.

These cancerous cells are also able to contaminate other parts of the eye as well as its supporting structures, such as the brain and spine.

While a genetic component to the mutation has been identified, there has not been conclusive literature on the exact cause of the mutation that leads to retinoblastoma.

What are the tests and treatments available for retinoblastoma?

There are multiple preliminary procedures that must be undertaken before a professional eye surgeon is able to provide a diagnosis, such as:

• Retinal examination , which involves an ophthalmologist who examines the patient’s retina through the use of an ophthalmoscope.
• Optical Coherence Tomography (OCT) that replicates a cross-sectional, three-dimensional (3-D) image of the inside of one’s eyes.
• Ultrasound, through the use of painless high-frequency sound waves, helps map out detailed recreations of the inner eye and eye socket.
• Fluorescein angiography is done through the injection of dye into a vein in the arm or hand, which is used to scan the retina and observe blood vessel integrity. This procedure is typically used to identify potential compromises in the structure or functionality of retinal blood vessels. 
• Electroretinogram, otherwise known as an ERG test, is used for measuring the electrical feedback of light-sensitive cells that can be found within the eyes.
• Bone scans help with determining the extent of retinoblastoma spread, particularly if the disease has progressed to neighbouring bones or the skull.
• Lumbar puncture (spinal tap), similarly to bone scans, tests for the presence of cancer cells in cases where retinoblastomas compromise the optic nerve and cause an increased likelihood of developing a tumour on the surface of the brain.
• Bone marrow aspiration and biopsy are tests that are only given when an eye surgeon has suspicions of retinoblastoma cells spreading beyond the eye and into the blood and bone marrow.

As for the treatment of retinoblastoma, it highly depends on both the severity and position of the tumour. Other factors that are considered are the extent to which the cancer has spread beyond the eye, the patient’s general health, comorbidities, and personal preference.

Optometrists, ophthalmologists and other eye professionals prefer treatments that avoid the potential for eye removal and vision loss whenever possible. Some examples of the treatments provided include:

• Periocular chemotherapy – which involves elevated doses of chemotherapy that is administered directly to the eye as a treatment for some advanced intraocular cancers, including retinoblastoma, while minimising the risk of systemic side effects.
• Intravitreal chemotherapy – where chemotherapy is performed directly into the vitreous humour, which is a gel-like substance that can be found within the eye.
• Radiation therapy – which utilises an advanced therapy technique called an intensity-modulated radiation therapy (IMRT) that enables precision in eliminating tumours while avoiding damage in nearby normal tissues.
• Photocoagulation – a technical term for the procedure involving a laser beam that is directed through the pupil to shrink and remove abnormal structures on the retina.
• Enucleation and eye prosthesis – which involves the surgical removal of an eye alongside a section of the optic nerve. In the worst case where vision has been compromised and a large tumour has made its way into the optic nerve system, an eye surgeon may perform this procedure. The patient may replace their lost eye with an artificial eye that is the same size and colour as the other eye post-surgery.

When it comes to retinoblastoma, it is important to schedule eye check-ups to ensure proper diagnosis and subsequent treatment of the disease. With EYECENTRIC under Bukit Tinggi Medical Centre, parents can expect exceptional eye care from an expert team of top ophthalmologists in Malaysia.

Through industry-proven clinical practices and state-of-the-art medical equipment, our highly experienced eye surgeons provide a variety of services from surgery to combat retinoblastoma, fix cataracts, and treatment of retinal disorders like retinal detachment and macular degeneration.