Look into their eyes and save their vision: role of primary health care provider in early diagnosis of retinoblastoma
Keywords:Primary health care provider, Red eye reflex, Retinoblastoma, Early diagnosis
Childhood cancer is not amenable to preventive or screening strategies. The most effective strategy to reduce the cancer burden and improve outcomes, is to focus on early, correct diagnosis followed by evidence-based therapy. When diagnosed early, they are responsive to appropriate therapy and increases survival rates, thereby reducing the need for intensive treatment and reduces the expenditure per child. Retinoblastoma is the most common intra ocular malignancy and is one of the most curable cancers in children. If diagnosed early and treated optimally, not only they are completely cured but a vast majority can have ocular salvage and retain vision. Lack of awareness among general population, diagnostic delays, delays in referral to proper treatment centre, compounded by socio economic factors attributes to the poor outcome in such children. We report a case of 2 years 10 months old girl child whose initial presentation of leukocoria was missed and later presented with advanced retinoblastoma with CNS metastasis.
Bhakta N, Force LM, Allemani C, Atun R, Bray F, Coleman MP et al. Childhood cancer burden: a review of global estimates, Lancet Oncol. 2019;20(1):e42-53.
Fadel SA, Boschi-Pinto C, Yu S, Reynales-Shigematsu LM, Menon GR, New Combe L. et al. Trends in cause-specific mortality among children aged 5-14 years from 2005 to 2016 in India, China, Brazil, and Mexico: an analysis of nationally representative mortality studies. Lancet. 2019;393(10176):1119-27.
Three Year Report of the Population Based Cancer Registries 2009-2011: Report of 25 PBCRs, National Cancer Registry Programme, Indian Council Medical Research, Bangalore. 2013.
Huang D, Zhang Y, Zhang W, Wang Y, Zhang P, Hong L et al. Study on clinical therapeutic effect including symptoms, eye preservation rate, and follow-up of 684 children with retinoblastoma. Eur J Ophthalmol. 2013;23:532-8.
Badhu B, Sah SP, Thakur SK, Dulal S, Kumar S, Sood A et al. Clinical presentation of retinoblastoma in Eastern Nepal. Clin Exp Ophthalmol. 2005;33:386-9.
Chawla B, Kumar K, Singh AD. Influence of socioeconomic and cultural factors on retinoblastoma management. Asia Pac J Oncol Nurs. 2017;4:187.
Kaliki S, Patel A, Iram S, Ramappa G, Mohamed A, Palkonda VKR. Retinoblastoma in India: clinical presentation and outcome in 1,457 patients (2,074 eyes), Retina. 2019;39(2):379-91.
Leander C, Fu LC, Pena A. Impact of an education programme on the late diagnosis of retinoblastoma in Honduras. Pediatr Blood Cancer. 2007;49:817-9.