What If Enucleation Is Necessary to Treat Retinoblastoma?

Pediatric retinoblastoma is a highly curable form of children’s cancer, but sometimes the eye cannot be saved. If your doctor recommends removing the eye to treat retinoblastoma, here are a few things that you should know about the procedure, your child’s vision, available prosthetics, and life after enucleation.

When Enucleation Is Necessary

While no one wants to hear that their child will be losing an eye, enucleation is often the safest way to treat retinoblastoma. Removal of the eye can help to eliminate the cancer before it spreads to other parts of the body. The entire eye will only be removed when the tumor has grown too large to remove from the eye while leaving the eye intact.

In many cases in which enucleation is recommended, the vision has already deteriorated substantially. In these cases, preserving the eye would not preserve the vision.

The Enucleation Procedure

The eye and part of the optic nerve are removed under sedation during the enucleation procedure. The surgery typically takes under one hour and is relatively uncomplicated, so patients are usually allowed to go home after surgery. A ball is placed in the eye socket until the socket heals enough to place a prosthetic.

Prosthetic Eyes

Prosthetic eyes look very realistic and are often difficult to tell apart from natural eyes. While it is not possible to repair vision after an eye has been removed, doctors can usually attach the eye muscles to a prosthetic eye so that all other eye functions including movement, blinking, and tearing can be performed as normal. A prosthetic eye can also help to prevent the eye from appearing sunken in as the bone and tissue of the face grows.

Adjusting to Monocular Vision

If one eye has been removed and vision remains in the other eye, it is known as monocular vision. With monocular vision it may be more difficult to judge depth and distance, the remaining eye may be very sensitive to bright light, and headaches may occur frequently due to eye strain. Since most children that have enucleation performed to treat retinoblastoma are very young, most adapt to these changes easily.

Enucleation of Both Eyes

In some cases, it’s unfortunately necessary to remove both eyes to treat retinoblastoma. In these cases, the child will be totally blind after the surgery. As with single enucleation surgeries, it’s possible to restore all functions besides vision to the eyes and use prosthetics to retain the normal face shape and structure as the child grows. Adjusting to life with a blind child is a shift for the whole family, but most children grow up to be healthy, well adjusted, and capable.