What is the first treatment for retinoblastoma?

Retinoblastoma is a cancer of the retina, the light-sensitive tissue at the back of the eye. Treatment is planned by paediatric oncology and eye specialists after an examination, imaging and assessment of whether one or both eyes are involved. The team aims to control the tumour, protect life and preserve as much useful vision as possible.

Chemotherapy circulates through the body and may shrink a tumour or make a local treatment easier. Brachytherapy places a small radioactive device close to a suitable tumour for a planned period, allowing treatment to be focused on the eye. The right sequence depends on tumour position, size, risk features and the child’s response.

Attend the specialist assessment promptly and bring a list of medicines, allergies and relevant family history. Ask which eye is affected, whether vision can be assessed, what the treatment goal is and how the team will check response.

Before chemotherapy, ask about infection precautions, nausea, appetite and when to call the hospital. Before brachytherapy, ask how the procedure is performed, how the eye is protected and what follow-up examinations will involve. Families may also be offered genetic counselling because some retinoblastoma patterns can affect future health planning.

Seek urgent specialist advice for a new white reflection in the pupil, a suddenly crossed eye, worsening redness or swelling, eye pain, a change in vision or a child who becomes unusually unwell. During treatment, call promptly for fever, repeated vomiting, poor drinking, marked sleepiness or severe eye pain. Children receiving cancer treatment can become unwell quickly, so the treating hospital should provide a direct emergency number.

Which eye or eyes are involved? What is the treatment goal? Is chemotherapy or brachytherapy recommended first, and why? How will vision be monitored? What symptoms need an immediate call? Does genetic counselling have a role for our family?