Retinoblastoma is a rare eye cancer that most commonly occurs in infants. It can affect one or both eyes. Without treatment, this condition may lead to vision loss and blindness.

Retinoblastoma begins in the retina, at the back of the eye. It can cause vision loss and blindness. However, seeking diagnosis and treatment early can help to prevent this.

Treatment is also important in helping prevent retinoblastoma from spreading to other areas of the body. When this occurs, it can be life threatening.

This article explains how retinoblastoma affects the eyes and vision. It discusses the risk of blindness, treatment options, and outlook.

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The retina is a layer of tissue at the back of the eye that contains light-sensitive nerve cells. These nerve cells connect to the brain, which interprets the light patterns or images, allowing us to see.

As a fetus develops, cells called retinoblasts mature to become the cells that form the retina. If a person has a certain genetic mutation in their retinoblast cells, a cancerous tumor can develop.

Without treatment, the cancerous cells can spread across the eyeball and may also form other tumors in the eye.

Retinoblastoma tumors can prevent fluid from circulating as usual within the eye. This can increase pressure within the eye and lead to glaucoma. Glaucoma is an eye condition that can cause vision loss.

Retinoblastoma can occur in one or both eyes.

According to a 2018 study, unilateral retinoblastoma does not lead to blindness. This is because unilateral retinoblastoma only affects one eye, leaving the other unaffected.

Bilateral retinoblastoma affects both eyes, meaning with this condition, blindness is possible.

The 2018 study looked at 44 children with bilateral retinoblastoma. It found that visual impairment occurred in 38% of cases and blindness in 19% of cases. Bilateral macular tumors were linked to visual impairment and blindness.

Retinoblastoma can either be hereditary or non-hereditary.

Hereditary retinoblastoma means a person inherits the condition from one or both parents. It accounts for around 40% of cases. Hereditary retinoblastoma can affect one or both eyes and can cause multiple tumors to form.

Non-hereditary retinoblastoma accounts for around 60% of cases. This type occurs through a random mutation, or a mutation with an unknown cause. Non-hereditary retinoblastoma only develops in one eye.

According to the American Cancer Society, treatment may depend on several factors. These include the type of retinoblastoma, the chance of preventing vision loss, and the extent of the cancer.

If retinoblastoma only affects one eye and there is a good possibility for saving vision, treatments may help preserve vision.

If retinoblastoma affects both eyes, treatments will aim to preserve as much sight as possible. If these methods are ineffective, surgery may be required to remove an affected eye.

Chemotherapy is the most common initial treatment for retinoblastoma. It can help to shrink tumors and may allow people to avoid surgery to remove the eye.

Treatments for retinoblastoma include:

  • Systemic chemotherapy: This involves administering chemotherapy intravenously to target cancer cells throughout the whole body.
  • Intra-arterial chemotherapy: During this treatment, a doctor will insert a thin, flexible tube into an artery near the pelvis. They will then feed it to an artery supplying blood to the eye. This allows them to deliver chemotherapy directly to the affected eye.
  • Intravitreal chemotherapy: With this type of chemotherapy, a doctor will inject the drug directly into the eye.
  • Laser therapy: Laser therapy uses heat to destroy cancer cells in the eye or the blood vessels allowing the tumor to survive.
  • Cryotherapy: Cryotherapy freezes tumor cells to destroy them. A doctor will place a specialized probe on the eye surface to freeze the cancer cells.
  • Radiation therapy: During this treatment, a doctor may place a small, temporary implant behind the eye. This allows them to kill cancer cells with radiation.
  • Surgery: Surgery may be necessary if the above treatments are not effective or there is a risk of the cancer spreading. Surgery involves removing the entire eye and replacing it with an artificial one.

People should speak with a doctor if they or a child in their care show any signs of retinoblastoma. Retinoblastoma usually occurs in children under the age of 2.

Early diagnosis and treatment can help improve outcomes for people with retinoblastoma. Attending regular check-ups may help detect any abnormal changes in the eyes.

If a child has an increased risk of retinoblastoma, they may need more regular testing. Risks include a family history of the condition.

Eye exams and MRI scans can help diagnose retinoblastoma, as well as blood tests for the genetic mutation that causes the disease.

People should also book an eye exam for a child if they notice a white reflection in the child’s eyes or in photos.

According to a 2023 review, advances in diagnosis and treatment of retinoblastoma have increased the survival rate to above 95%.

In the United States, treatment can cure retinoblastoma in over 9 in 10 cases. However, a person’s outlook may worsen if the cancer spreads outside the eye.

People with hereditary retinoblastoma have a higher risk of the cancer spreading outside of the eye.. If this occurs, a tumor may form in the brain or in other areas of the body.

According to the American Cancer Society, many children with retinoblastoma will have a normal life expectancy. Although, people may experience some effects of the cancer or treatments later in life.

The outlook for vision loss and blindness may depend on whether retinoblastoma affects one or both eyes. It can also depend on the type of treatment a person requires. A change or loss of vision in the treated eye may also occur in later life.

Retinoblastoma can cause vision loss and blindness, although early treatment may help prevent this.

If retinoblastoma only affects one eye, a person will still have vision in the unaffected eye. If retinoblastoma affects both eyes, treatment may help to prevent sight loss. In some cases, people will need surgery to remove the affected eye.

Early diagnosis and treatment may help improve outcomes for people with retinoblastoma. With effective treatment, the overall survival rate is high.