Retinoblastoma Symptoms

Retinoblastoma symptoms may be difficult to observe, especially in infants and small children. Retinoblastoma symptoms are typically apparent as discoloration and misalignment in the affected eyes. Parents and guardians who note abnormalities which coincide with retinoblastoma symptoms should speak with a pediatric optometrist or pediatric ophthalmologist as soon as possible. Doctors and patients should note that many retinoblastoma symptoms may also be present in other types of eye diseases.

Retinoblastoma Eye Discoloration

Retinoblastoma symptoms involve certain types of discoloration in the affected eyes. In many cases, first retinoblastoma symptoms are detected in photographs when the child’s pupil appears white instead of black. Other discoloration symptoms may develop over time as the cancer grows within the eye.

Retinoblastoma eye discoloration may be seen in:

  • Leukocoria, or a white pupil. Leukocoria is most often observed in photos when a flash was used. Leukocoria indicates that light was reflected off of the white tumor, as opposed to the retina.
  • Heterochromia, or discoloration of the iris. This is caused by the formation of new blood vessels on the surface of the child’s iris.

Retinoblastoma Alignment Symptoms

Retinoblastoma symptoms may be indicated when the child’s eyes are not in correct alignment. This typically occurs when the retinoblastoma tumor interferes with the child’s vision. As a result, the brain does not receive a sufficient stimulus to keep proper eye alignment.


Strabismus is defined as the misalignment of the eyes. After discoloration, misalignment is the second most observable of the retinoblastoma symptoms. There are two main types of strabismus: esotropia and exotropia. Esotropia occurs when the eyes turn inward. Exotropia occurs when the eyes turn outward.

Advanced Retinoblastoma Symptoms

In advanced cases, retinoblastoma symptoms may be seen in red and swollen eyes. The eyes may also appear to protrude from the orbit, or sockets. These retinoblastoma symptoms occur when the child’s body reacts to the cancer in a similar manner that it would react to an infection. Additionally, advanced retinoblastoma symptoms may involve eye pain. However, this can be difficult to determine in infants and small children, as they may not be capable of communicating this pain to adults and doctors.

Observing Retinoblastoma Symptoms

Once notified of potential abnormalities, a pediatric optometrist or ophthalmologist will examine the child’s eyes for retinoblastoma symptoms. The initial retinoblastoma examination will typically involve a careful examination. During this examination, the child’s eyes will be dilated. Dilation typically involves the administration of eye drops. These eye drops contain special ingredients that will cause the child’s pupils to dilate, or expand. The dilation allows for more careful examination of the pupil in order to determine abnormalities.


Fragkandrea, Ionna, John Alexander Nixon, and Paraskevi Panagopoulou. “Signs and Symptoms of Childhood Cancer: A Guide For Early Recognition.” American Family Physician 88.3 (2013): 185-192. MEDLINE with Full Text. Web. 29 Nov. 2013.

Kah, Tan Aik, and Faridah Hanom Annuar. “Images in Clinical Medicine. Retinoblastoma.” The New England Journal of Medicine 367.3 (2012): 258. MEDLINE with Full Text. Web. 29 Nov. 2013.

Melamud, Alex, Rakhee Palekar, and Arun Singh. “Retinoblastoma.” American Family Physician 73.6 (2006): 1039-1044. MEDLINE with Full Text. Web. 29 Nov. 2013.

“What Is Retinoblastoma?” St. Jude’s. St. Jude Children’s Research Hospital. Web. 29 Nov 2013. <>.