Although this tumor has a high cure rate, it can cause lifelong disability.

"Among infant and young children's diseases, besides leukemia, there is a tumor that is the most common and the most harmful. It occurs in the nuclear layer of the retina and is called retinoblastoma. This type of disease ranks second in the incidence and harm list, second only to leukemia, and should not be underestimated," said Shi Jitong, director of the Department of Ocular Oncology at Beijing Tongren Hospital.

Although the cure rate of retinoblastoma is as high as over 80%, the cost is removal of the eyeball.

Director Shi explained that the most common clinical manifestation of retinoblastoma in the intraocular stage is white pupils like cat's eyes in infants and young children, that is, loss of vision, and yellow-white reflections in the pupil area, just like a cat's eye, sparkling.

"Normal" parents can also give birth to sick children

Retinoblastoma is a malignant tumor related to heredity, chromosomal aberration, viral infection, etc. 90% of patients are infants under 3 years old, a few occur in older children, and occasionally adults also develop the disease.

Director Shi said that this disease is more common in one eye, accounting for about 70%, and about 30% of patients develop the disease in both eyes at the same time or successively. 100% of patients with bilateral disease are genetically caused, while 10%-15% of patients with unilateral disease are mostly hereditary, often chromosomal dominant inheritance, with incomplete penetrance (there are gene defects but not necessarily clinical manifestations), so the surface is normal, and parents with pathogenic genes may not develop the disease, but they can give birth to sick children. In general, hereditary and non-hereditary factors in retinoblastoma account for 30%-40% and 60%-70% of all patients. Chromosome studies have also proved that some patients have chromosomal abnormalities, and found that the long arm of chromosome 13 is missing or the gene is mutated.

Four phases of clinical manifestations

According to Director Shi, retinoblastoma is clinically divided into 4 stages:

Intraocular growth stage: The eyes are normal, but the vision is already abnormal. Because most children have not yet started to speak, it is not easy for parents to find out;

Glaucoma stage: As the tumor gradually grows and increases in size, the contents of the eye increase, causing increased intraocular pressure and secondary glaucoma.

Extraocular spread stage: The earliest thing that happens is that the tumor cells spread along the optic nerve into the skull;

Systemic metastasis stage: The most serious stage is the systemic metastasis stage, but metastasis can occur at any stage. For example, a tumor occurring near the optic nerve head can be life-threatening even if it is very small.

Be vigilant, detect early and treat early

Director Shi explained that the most common clinical manifestation of the disease in the intraocular stage is white pupils like cat's eyes in infants and young children, that is, loss of vision and yellow-white reflections in the pupil area, just like a cat's eye.

Director Shi pointed out that this disease is relatively easy to treat in the intraocular stage and the glaucomatous stage, because there is an eye wall interval, the tumor does not spread everywhere, and the tumor can be removed by removing the eyeball, and the recurrence is rare. Therefore, children with "cat eyes" must be vigilant, discover and treat them as early as possible. If the time is delayed and the disease develops to the extraocular stage or metastatic stage, the orbital contents may need to be removed. If the disease progresses rapidly, it may not be enough to remove the eyeball, which is very likely to lead to death.

High cure rate, but lifelong disability

"In fact, the cure rate of retinoblastoma is as high as 80%-90%, which is the tumor with the highest cure rate. But the price is often to remove the eyeball, and many parents evade and give up when they hear this, and the final result is the death of the child."

Director Shi said that generally, most children will have artificial eyes installed after their eyeballs are removed, so the psychological barriers are relatively small. If the disease reaches the late stage, the eye sockets need to be removed, resulting in exposed facial bones, which will make the face look ugly and more prone to recurrence, with the recurrence rate increasing by more than 50% compared to simply removing the eyeballs.

Don't take the risk of having a second child.

"Children with the disease can start a family when they grow up, but the disease is dominant, so the next generation has a 50% chance of developing the disease. If a child has this tumor in both eyes, it is undoubtedly hereditary. From the perspective of eugenics, he or she is not suitable for childbearing." Director Shi lamented, "If one of the parents has the disease, the child they give birth to has a high chance of getting the disease. Even if the child survives and starts a family, his or her children may also get the disease." Therefore, experts recommend that if there is a clear family history of retinoblastoma, one must carefully consider the issue of whether to have children; if a child already has the disease, it is best not to take the risk of having a second child.

Eliminate congenital eye diseases from the source

Couples who want to have children should pay attention to their living habits before pregnancy, quit bad habits such as smoking and drinking, and it is best to go to the hospital for a health check to rule out hereditary eye diseases and eliminate hidden dangers. Maintain a good lifestyle during pregnancy. It is best not to use medication in the first three months of pregnancy. If necessary, follow the doctor's advice. Some viral infections such as rubella, chickenpox, herpes simplex virus, etc. may cause congenital cataracts and other diseases in the fetus. Therefore, mothers must pay attention to preventing viral infections during pregnancy, especially in the first 3 months.

After the baby is born, the eye examination should be carried out regularly. The eye health should be paid attention to at ordinary times. If there is any abnormality, the baby should seek medical attention immediately. Do not use medicine at will to delay treatment. If the baby's eyes are red and accompanied by increased eye secretions, it indicates conjunctivitis or neonatal dacryocystitis; if the baby's eyes have a lot of purulent secretions, it indicates that the conjunctivitis may be caused by a strong bacterial infection; if the baby's eyes are large, especially the "black eyes" are large, accompanied by fear of light and tears, you should be alert to the possibility of congenital glaucoma.

If you find your baby's pupils are white, you should take your baby to see an ophthalmologist immediately. The most common cause is congenital cataracts. If you find your baby's eyes are green at night, commonly known as "cat's eyes", it indicates the risk of retinal tumors. Parents should pay attention to your baby's "crossed eyes", drooping upper eyelids, and tilted heads. Children who are too young cannot communicate with others, and some conditions may be ignored. Therefore, parents who are closest to their babies should be vigilant and not miss the opportunity, which will cause lifelong regrets.

Source: Science and Technology Daily

Reprinted from: Tongren Eye Foundation