Exophytic retinoblastoma

Retinoblastoma is a cancer of the retina, the light-sensitive tissue at the back of the eye. In an exophytic pattern, the tumour grows away from the retina and can cause fluid to collect beneath it, which may affect vision. A white reflection in the pupil, a new squint, a red or painful eye, or reduced vision can be warning signs, but only specialist examination can establish the cause. The appearance and extent of the tumour are assessed with imaging and an examination of the eye, often while the child is asleep.

Arrange prompt review with a paediatric eye cancer team if retinoblastoma is suspected or diagnosed. Treatment aims to control the tumour, protect life and preserve the eye and useful vision when possible. The plan may include Chemotherapy, focal treatment, or an eye-directed approach such as Brachytherapy. The choice depends on tumour size, position, number of lesions, pressure within the eye and whether one or both eyes are involved. Follow-up examinations are needed because the eye can change after treatment and children require ongoing care.

Seek urgent assessment for a painful red eye, sudden change in vision, a new white pupil reflection, marked swelling, vomiting with severe headache, or unusual sleepiness. Contact the specialist team quickly if a child develops a new squint or if an existing eye sign changes. Do not postpone assessment while waiting to see whether the sign disappears; early review helps protect the eye and guides safe examination.

Which eye is affected, and where is the tumour located? Is the pattern limited to the eye? What is the goal of each treatment? Could Brachytherapy or Chemotherapy be suitable? How often will examinations be needed, and what changes should prompt an urgent call?