Retinoblastoma

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 drchang@avenueeyecare.com

What’s the difference between an infant and an adult eye exam?

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When I give community education seminars to mom and tot groups,
parents are often surprised that children as young as 6 months old can
get their eyes examined.  Parents are so used to having to answer
“which is better, one or two?” and since their babies can’t speak,
they assume they’re too young for an eye exam.  Optometrists use
different techniques for infant eye exams that don’t require speech.
For example, we use a retinoscope to estimate a baby’s prescription.
Your baby will need to focus on an object (we use videos at Avenue
Eyecare) and with the use of handheld lenses and the retinoscope, we
look at the reflex of light from your baby’s retina to ensure their
prescription is in the normal range for their age.  Another important
thing to check for is eye alignment.  This is simply done by observing
how their eyes work together while following and object (usually  toy)
and measuring how evenly light reflexes line up on the cornea.  We
also screen your child’s eyes for congenital diseases such as
congenital cataracts and retinoblastoma.

We’ll be at the “bellies to babies” convention this Sunday from
11am-4pm at the Croatian cultural centre.  If you’re interested in
learning more or looking at some of the equipment we use, come visit
us at our booth.  We will have some great prizes and giveaways.

Here’s the link to the event:http://belliestobabiescelebration.com/

Dr. Jessica Chang, OD drchang@avenueeyecare.com