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| "Do not go where the path may lead, go instead where there is no path - and leave a trail." ~ Ralph Waldo Emerson ~ |
| ORPHANS OF THE CANCER STORM |
| Disclaimer This information page has been prepared by an individual who does not have medical training. However its contents have been reviewed by appropriately qualified medical professionals for accuracy and quality. This page is intended for information purposes only and should not be used as a guide to diagnosis or treatment. If this information raises any concerns about your child’s condition or care protocol, discuss them with his or her paediatrician, oncologist, or other appropriate medical professional who has knowledge of the case. |
| The white reflex is not necessarily a sign of retinoblastoma. It is also a symptom of several other eye conditions, such as Coat's Disease or a blond fundus. However, in young children, it should be considered the most likely diagnosis, and investigated promptly with a dilated eye examination. |
| the most easily recognised symptom of retinoblastoma is an abnormal appearance of the pupil, which reflects light as a white reflex, like a cat's eye. This is known as "leukocoria". Leukocoria is usually only visible in low level artificial lighting or in photographs where a flash has been used, such as in the examples below. |
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| If you see a white reflex in your child's photoraph, compare it to other photographs in the same set and, if possible, ask friends/family to examine their own photos taken on the same occasion to see if more photos have the reflex. Look at previous photos of your child too. If the reflex appears in a single picture or in several pictures taken from the same position on the same real, whilst all other photos show normal red reflex, the reflex is likely to be the result of the angle of the flash light. |
| Check all children's photographs thoroughly, especially those taken in low light conditions. Retinoblastoma specialists recommended that a child's picture be taken once a month in a dimly lit room for the purpose of checking for a normal red-eye reflex. It is essential for the child to be seen immediately by a paediatric ophthalmologist (a children's eye doctor) if you ever find a white reflex, such as in the photographs on this page. |
| Ensure your child's eyes are examined with an ophthalmoscope in a darkened room at every well child visit. This simply involves shining the ophthalmoscope in the child's eyes. If a white reflection is seen in the pupil of the eye, something that does not belong in the eye is reflecting back light. Retinoblastoma should be considered the most likely diagnosis in young children, and eyes should be examined by a specialist as a matter of urgency. |
| Flash photography may cause the white reflex to appear in perfectly healthy eyes. This depends on the angle at which the light hits the optic disc. However, a white reflex in a child's eye should always be checked out by a children's eye doctor. All the photographs on this page are of children diagnosed with retinoblastoma. |
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| As you can see from these two pictures, photographs of a child who has retinoblastoma do not necessarily catch the leukocoria every time. This depends on the angle of the photo, and on the position of the tumour(s). |
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| Similarly, if a child has tumours in both eyes, a single photo may catch leukocoria in only one eye. You can see this in the following three photos of the same child, who has bilateral Rb. |
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| The shade and clarity of the leukocoria may also vary between photos, as you can see in the following three pictures of the same child. |
| Leukocoria: the "cat's eye" reflex. |
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| Retinoblastoma is potentially fatal. However, it is also entirely treatable. Children do not die from primary tumours in the eye, but from cancer which has spread beyond the eye due to late diagnosis. Correct monitoring at regular paediatric exams, and prompt investigation of any leukocoria should ensure that Rb never remains undetected. |
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| The following two posters highlight the significance of leukocria in diagnosing retinoblastoma. |
| Joey Bergsma's retinoblastoma was diagnosed too late, and he died at the age of three. If his parents had known about retinoblastoma and leukocoria, they would have taken him to the doctor right away. He died from an entirely treatable cancer. This poster was produced for his grandmother's awareness campaign, in the hope that no other family would have to face such a loss.. |
| In 2003, the United Kingdom Childhood Eye Cancer Trust launched it's "See Red" awareness campaign, sending a copy of the following poster to every General Practice surgery in the country. The success of this campaign led to the 2004 mailing of posters to every paediatrician in the country. The poster explains how the ophthalmoscope should be used, and when doctors should suspect that there is a problem with a child's eye or eyes. |
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