I recently had a mini-reunion with some of my closest friends from optometry school and we started chatting about rare cases we’ve come across over the last few years. I remember we used to wonder if we’d ever see the rare and random conditions we’d learn in class, and unfortunately we do. My professor used to say “It’s not rare, if it’s in your chair!”
My friend shared a case about a 2 year old she saw, who had a rare cancerous tumour in one of her eyes, called retinoblastoma. There are about 350 new cases per year in the U.S. and most cases affect only one eye. It’s caused by a gene mutation that controls cell division. There is a family correlation (hereditary component) in some of the cases. This tumour usually affects children under the age of 6, so it’s definitely something all optometrists look for in pediatric eye exams.
Here are some important signs parents can look for:
1. A white pupil (also known as leukocoria)
2. A crossed eye (either inwards or outwards)
3. Differing iris colors (also known as heterochromia)
4. Poor vision
5. Eye pain and redness
My friend’s patient had different scans done immediately to confirm the presence of the tumour and they checked if it had spread to any other part of the body. Treatment options include enucleation (removal of the eye), radiation and laser treatment, chemoreduction, and cryotherapy. In this case, based on the evaluation done by the ophthalmologist, the patient was flown to Toronto for enucleation.
I hope I never see one of these cases in my career, but it’s a big reminder about why I’m such a strong advocate for routine children’s eye exams
Dr. Jessica Chang, OD firstname.lastname@example.org