About Eye Cancer in Children

Overview

Eye cancer in children refers to a condition called retinoblastoma, which is the most common type of eye cancer in children. It starts in the retina, which is the light-sensitive structure at the back of the eye. Retinoblastoma can affect one or both eyes and may lead to blindness if left untreated. While it is rare, accounting for approximately 2 in 100 childhood cancers, it can be life-threatening. Children younger than age 5 are most commonly affected by retinoblastoma, although it can also occur in older children and adults in rare cases. Some common symptoms include a white pupil, crossed eyes, red eyes, eye pain, bulging eye, and reduced vision. Prompt diagnosis and treatment can lead to a good outlook for children with retinoblastoma.

Causes and Risk Factors

The causes of eye cancer in children are primarily genetic changes or mutations in genes that lead to uncontrolled cell growth. These genetic changes can be inherited from parents or occur spontaneously during development.

The non-modifiable risk factors of eye cancer in children include:

• Race: The risk of eye melanoma is higher in white people.
• Eye color: People with light-colored eyes, such as blue or green, have a higher risk of uveal melanoma.
• Family history: Having immediate family members with a history of eye cancer increases the risk.
• Some inherited familial syndromes, like Li-Fraumeni syndrome and von Hippel-Lindau syndrome, are associated with an increased risk.

Modifiable risk factors of eye cancer in children are not well-established.

Symptoms

The most common early symptom of eye cancer in children, specifically retinoblastoma, is a white pupil. This is often the first sign that doctors notice. Other early symptoms may include teary or watery eyes, crossed eyes or one eye that drifts in a different direction, poor vision, and eye redness, pain, or swelling.

As eye cancer progresses or becomes more severe, additional symptoms may occur. These can include:

• Crooked eyes (strabismus)
• Eye bulging
• Reduced vision
• Eye inflammation
• A visible growth on the eye

It's important to note that these symptoms can vary depending on the individual and the stage of the cancer. If you notice any concerning symptoms in your child's eyes, it's essential to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

Diagnosis

To diagnose eye cancer in children, several examinations, tests, and procedures may be performed. These include:

• Eye exam with dilated pupil: The doctor will use medicated eye drops to widen the pupil and examine the inside of the eye, including the retina and optic nerve.
• Ophthalmoscopy: This exam uses a small magnifying lens and light to check the back of the eye.
• Ultrasound: Sound waves are used to create images of the eye, providing a better look at the tumor and surrounding tissues.
• Optical coherence tomography (OCT): This noninvasive ultrasound device provides a real-time, cross-sectional view of the retina.
• Fluorescein angiography: A fluorescent dye is used to help the doctor identify abnormal blood vessel growth or other conditions affecting the eye.
• CT scan or MRI scan: These imaging tests create detailed images of the eye and surrounding structures.

To determine the stage or severity of eye cancer in children, additional examinations and tests may be necessary. These can include:

• Repeat imaging tests: Regular imaging tests such as ultrasounds or CT scans may be done over time to monitor changes in tumor size and growth rate.
• Biopsy: A small sample of tissue is taken from the tumor for further analysis to confirm the diagnosis and determine the specific type of cancer.

It's important to consult with a doctor if your child experiences vision changes or any possible symptoms of eye cancer without a known cause. Early diagnosis increases the chances of preserving vision.

Treatment Options

The goals of treatment for eye cancer in children are to save the child's life, preserve vision and the eye, and prevent serious side effects. The treatment options for retinoblastoma include:

Medications:

• Chemotherapy: Drugs are used to kill cancer cells or stop their growth.
• Intra-arterial chemotherapy: Chemotherapy drugs are delivered directly into the artery supplying blood to the tumor.
• Intravitreal chemotherapy: Drugs are injected into the vitreous gel of the eye to treat tumors within the eye.

Therapies:

• Laser therapy: A focused beam of light is used to destroy small tumors or seal leaking blood vessels.
• Cryotherapy: Extreme cold is used to destroy abnormal tissue.

Therapeutic Procedures:

• Enucleation: Surgical removal of the affected eye may be necessary in some cases.

Self-care and Health Behavior Changes:

• Regular follow-up visits with a pediatric oncologist and other specialists.
• Adherence with medication schedules and treatment plans.

These treatments work by targeting and destroying cancer cells, shrinking tumors, preventing tumor growth, and preserving vision. However, it is important to consult with a healthcare professional for personalized advice and guidance regarding treatment options and their effectiveness for individual cases.