This is a real case that happened in the United States not long ago. A photo taken under a flash lamp has become the key to saving the child’s life.
In the front photo taken by the mobile phone below, mother Julie Fitzgerald found that her son’s right eye was [red eye], while his left eye was eerily white.
With doubt, the mother first searched the Internet and then turned to the doctor for help. The son was finally diagnosed with retinoblastoma in his left eye, and his left eye was removed by surgery, saving his life.
What is retinoblastoma?
Retinoblastoma, or Rb for short, is the most common intraocular malignant tumor in infants, 95% of which are found before the age of 5 . It can occur in one eye, two eyes at the same time or in tandem.
Retinoblastoma is a malignant tumor, which easily spreads to surrounding organs or [sows] other parts of the body.
The eyeball is directly connected to the brain through the optic nerve behind it. Tumor cells can also easily pass through this bridge and grow directly into the brain, posing a serious threat to life. This is its most terrible place.
At present, it is believed that this tumor tissue is caused by inactivation of [retinoblastoma gene (RB)].
RB is the first [tumor suppressor gene] discovered by human beings. As the name implies, it can prevent malignant changes in cells.
When the RB gene and the protein produced through it are inactivated, the affected cells will grow uncontrollably and abnormally, eventually triggering tumors.
This genetic abnormality can be inherited or caused by the gene [itself]-that is, gene mutation. However, even if there are no other patients in the family, it may be [hereditary].
Can retinoblastoma be found under flash light?
When taking photos with a flash, if the human eye looks directly at the light source, there will often be [red eye], just like the child’s right eye in this case. This is the orange reflection of fundus retina and choroidal tissue that can be seen in the round pupil area.
The color of retinoblastoma growing on the retina is usually grayish white or yellowish white. If strong light enters through the pupil, the reflected light is close to white.
Therefore, this phenomenon is called [white pupil disease] or [cat’s eye].
This is the most common symptom of the disease. Even when the light is weak, some careful parents may find this abnormality.
However, to find it through these methods, there is a prerequisite: only when the tumor is large enough and close enough to the central axis of the eyeball can obvious white reflection be formed; Otherwise, it may be covered by the red light of other normal tissues.
Therefore, it is the most reliable way for doctors to examine under ophthalmoscope.
In addition, children with retinoblastoma may also have manifestations such as invisibility, strabismus, red eyes, eye pain, even exophthalmos, red eyelid swelling, etc., but they are usually found later than [white pupil syndrome].
[White pupil] Must it be a tumor?
For children, eye abnormalities are often found by parents, and [white pupil syndrome] generally refers specifically to whitening of children’s pupil region.
White light can come from other abnormal tissues and parts.
In other words, in addition to retinoblastoma, there are many possible causes of [white pupil disease], the common ones are:
- Congenital cataract; Endophthalmitis; Persistent primitive vitreous hyperplasia; Retinal detachment includes primary retinal detachment or secondary retinal detachment caused by premature retinopathy, Coats disease and other diseases.
How found out in time?
The children of patients with hereditary retinoblastoma have a 40% ~ 50% possibility of the disease.
For the following high-risk groups, there are stricter follow-up requirements, which generally require examination every 3 months, and the frequency of follow-up can be appropriately reduced when they grow up:
- Retinoblastoma has been diagnosed in one eye and is temporarily normal in the other eye;
- Immediate family members, such as parents or brothers and sisters, suffer from retinoblastoma;
- It is suggested to carry out gene diagnosis and genetic counseling to understand other situations requiring follow-up.
Children who do not belong to high-risk groups may also suffer from non-hereditary retinoblastoma.
2. Parents’ how found out in time?
At present, there is no clear prevention method, only as early as possible to find and treat. Parents should do these things:
- Regular prenatal examination for pregnant women and eye examination for newborns must be done. Teach children to watch the visual chart as soon as possible; Attention should be paid to the observation of children’s abnormalities such as [white pupil disease], protruding eyes, or crying with only one eye, as long as the eye is blocked. We should clearly understand whether there are patients with the disease in the family. Finally, once abnormalities are found, we must see a doctor in time.
How to treat retinoblastoma?
What many doctors saw during the reception was painful: The tumor has developed to an unmanageable level, even propping up the eyeball to be bigger than goose eggs, bloody and beyond recognition. Clearly diagnosed early, it is likely to be cured by removing the eyeball. However, some parents did not follow the doctor’s advice, but went everywhere to look for [folk prescription], or gave up treatment directly, until the tumor spread and the child died in pain.
At present, enucleation of diseased eyeball is still the most important and effective method to treat retinoblastoma. Of course, the treatment plan should be determined according to the specific condition.
As mentioned at the beginning of the article, tumors found by [white pupil syndrome] are often relatively large in volume, and the eyes often lose the function of seeing things. Fortunately, no abnormality has been found in the other eye for the time being.
At this time, surgery to remove the diseased eyeball is the best treatment plan, and sometimes combined chemotherapy and other methods are required.
If it can be found early, there may be an opportunity to try other conservative treatment methods before enucleating the eyeball.
If you are lucky enough, you may not only keep your eyeballs, but also have some eyesight.
In a recent report in Britain, the 5-year survival rate of children with retinoblastoma treated in a standardized way can reach 99%, which is the highest among children’s tumors . In a study in our country, this data also reached 78.79% . It should be said that considering that many children in our country are found late, the therapeutic effect is quite good.