Endophytic retinoblastoma: what to know

Retinoblastoma is a cancer of the retina, the light-sensing layer at the back of the eye. In the endophytic pattern, the tumour grows inward toward the vitreous, the clear gel filling the eye. This can make the eye look cloudy or show a white reflection in the pupil, and vision may change. These signs can have other causes, but a new white pupil or abnormal eye appearance needs prompt assessment.

Specialists examine the eye carefully, often while the child is anaesthetised, and use imaging to assess both eyes and nearby structures. The treatment plan balances controlling the tumour with protecting vision and the child’s wider health.

Care should be coordinated by a specialist retinoblastoma team. Depending on tumour size, location and spread, treatment may include medicines delivered to treat cancer, focal treatment or surgery. Chemotherapy may be considered when medicine is needed for disease control. Brachytherapy uses a small radiation source placed close to a selected eye tumour; suitability depends on the individual findings.

Ask about genetic counselling, examination of siblings when advised, and follow-up for the treated eye and the other eye. Bring questions about vision, school, anaesthesia and emotional support.

Seek urgent specialist advice for a new white pupil or white reflection in a photograph, a sudden change in vision, a painful red or swollen eye, a new squint, or an eye that appears larger. After treatment, urgent review is needed for fever, marked lethargy, severe eye pain, swelling or sudden visual change.

Ask: Is the tumour confined to the eye? What is the aim of each treatment? Can vision be protected? What examinations will siblings or relatives need? How often will follow-up continue, and which symptoms should prompt an emergency call?