Retinoblastoma can be prevented if diagnosed early

Kathmandu, May 10: Retinoblastoma (RB) is a fast growing eye cancer affecting babies and children, and its early diagnosis is vital to save children’s life and sight. 

However, detection of early sign of RB is challenging as very young children cannot tell parents that their eyesight is changing, according to doctors. 

Dr. Rohit Saiju, a consultant eye surgeon, said, “A white glow in a child’s eye, seen in flash photos or dim light are the most common early sign of RB.” 

Moreover, white colour appearing in the pupil, eye appearing to be looking in different directions, redness and swelling are common symptoms, informed Dr. Saiju. 

Dr. Saiju said that around 90 per cent of the children are diagnosed with RB as many parents notice the sign.  But parents ignore the symptoms due to the lack of awareness and they delay seeking medical help, which may lead to loss of vision or even death, added Dr. Saiju. 

According to Dr. Purnima Rajkarnikar Sthapit, an ocular oncologist, RB is completely curable if detected earlier but awareness about it is low. 

With improved techniques and technologies, survival of children with RB has improved, but low awareness is still a cause of concern, said Dr. Sthapit.

Children’s life, eye and vision can be saved if they are examined by a child specialist or an eye doctor, or an eye cancer specialist for treatment, according to doctors. 

Public campaign is necessary to make people aware and emphasise the screening of children for the white reflex. The screening of children should be made a standard clinical practice. 

RB is often not diagnosed until later stages and the eyeball may be worsened due to increased possibility of spread of tumor to other parts of body by the time it is diagnosed.  

RB represents 5 per cent of all childhood cancers and it is rapidly growing fatal eye cancer. It is the most common intraocular malignancy in children, with a reported incidence ranging from 1 in 15,000 in 18,000 live births. 

The mortality rate of this fatal cancer is 5 per cent in developed countries, 50 per cent in developing countries, including Nepal, and can reach 99 per cent if left untreated.  Around 40 per cent of RB cases are hereditary and is developed from infancy while 60 per cent are inherited cases, according to doctors. 

As per a study carried out by the Tilganga Institute of Ophthalmology, 32.1 per cent of patients who had underwent surgery of bones near eyes were found to have RB. 

Dr. Sthapit said that one eye is affected among 60 per cent of children suffering from RB while both eyes are affected among 40 per cent of such children.  

Doctors have said that pediatricians have important role to play in early detection of RB and proper referral. They have suggested the concerned authorities to have a small pocket ophthalmoscope in all pediatric clinic. For early detection of the disease, neonates should be discharged only after examining the glow, said Dr. Sthapit.  

The World Retinoblastoma Awareness Week is celebrated around the world from May 8 to 14 to raise awareness about the disease.