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Know the Glow: Your Eyes Can Detect a Rare Childhood Cancer

Nowadays our smartphone cameras are on hand for every one of our children’s firsts—from rolling over and walking to first words and first days of school. But did you know the flash of your smartphone may also be able to capture cancer in their eyes?

While the red-eye effect can be a nuisance when you use a flash, a white or yellow glow in your child’s eyes could signal a serious eye disease called retinoblastoma.

Retinoblastoma is a rare type of cancer that forms in the retina (the light-sensitive tissue at the back of the eye) and usually develops before the age of 5. It can be caused by a genetic mutation that can be inherited or, in some cases, it can occur without a family history.

“It makes up about 3% of all childhood cancers, and there is about one case in every 16,000 live births around the world,” said Joseph Torkildson, MD, a pediatric hematologist and oncologist with Banner Children's.

Read on to learn about retinoblastoma and how to recognize the glow.

Know the glow: The signs and symptoms of retinoblastoma

The most common symptom of retinoblastoma is when the retina looks white. This is called leukocoria. The second most common is strabismus, when the eyes are crossed or ‘lazy’ in appearance. Most often these symptoms are first noticed by parents and loved ones.

“About 80% of cases are diagnosed by parents or family members who notice a ‘white eye’ or notice their child isn’t seeing normally.” Dr. Torkildson said.

The next time you take your child’s photo, take a closer look. When flash photography creates a white glowing pupil in the eye of a child, it could be that the light is illuminating a tumor not otherwise visible. In fact, now there’s an app for this. Bryan Shaw, a chemist and father, invented the CRADLE White Eye Detector app after his own son Noah’s tragic experience to help speed up diagnosis and treatment.

Although a glow in the eye isn’t always indicative of a tumor, a visit to your child’s doctor is a good precautionary measure. With early diagnosis and timely treatment, in most cases, a child’s eyesight and life can be saved.

Diagnosing retinoblastoma

In most cases, a diagnosis of retinoblastoma is first noticed by parents or family members, either noticing the glow in their child’s eyes or that their child isn’t seeing normally. Pediatricians and family physicians also detect cases at well-child visits where they scan a light in the child’s eyes and look for loss of the normal “red reflex.” If retinoblastoma is detected, your child’s doctor may refer your child to an oncologist or other specialist.

Treating retinoblastoma

In the U.S. where advanced treatment is readily available, the prognosis for retinoblastoma is excellent: 98% of patients survive their disease, 90% are able to have their eyes saved and 80% of eyes retain some quality of vision.

Retinoblastoma requires the help of different specialists, which may include ophthalmologists, pediatric oncologists, radiation oncologists and occupational therapists. When it comes to treatment, management of retinoblastoma is focused on three sequential goals, Dr. Torkildson said: life salvage, eye salvage and optimal vision.

“The choice of a treatment strategy depends on the classification of the disease at diagnosis,” he said. “This divides tumors into groups and stages depending on the size and distribution of disease within the eye and extent of the disease after surgery or initial intervention.”

For children with small or moderate sized tumors, treatments may include vision-sparing therapies such as chemotherapy injected directly into the artery feeding the eye, as well as local treatments including cryotherapy (freezing), transpupillary thermotherapy (heating) and laser therapy.

For larger tumors or for eyes with complete loss of vision, removal of the eye (enucleation) is usually recommended. And in cases where the cancer has spread beyond the eye, systemic chemotherapy is used.

Outlook: What parents should expect

Hearing your child has cancer is overwhelming and scary—no matter whether it’s highly curable or not. That’s where having a highly-skilled and caring team can guide you through diagnosis and treatment—ensuring your child receives the very best care and clinical outcomes.

“One has to acknowledge parents’ fears, because cancer is, in fact, a frightening thing,” Dr. Torkildson said. “The best approach to take with families is to reassure them that their oncologist will always be honest with them regarding their child’s likelihood of being cured, of experiencing complications or side effects. It’s important for them to know, they are never alone.”

If you think something is wrong with your child’s eyes, don’t hesitate to schedule an appointment with your child’s healthcare provider. To find a specialist near you, visit bannerhealth.com.

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