Retinoblastoma can present in a variety of ways.
The majority of retinoblastoma patients present with a white pupil
reflex or leukocoria instead of a normal healthy black pupil
or red reflex similar to the one seen when photographs are taken
of a child looking directly into the camera. This abnormal white
pupillary reflex is sometimes referred to as a cat's eye reflex.
Many times the parent is the first one to notice
the cat's eye reflex. Other eye diseases can also present with this
white pupillary reflex; leukocoria does not always indicate retinoblastoma.
An ophthalmologist can determine the correct diagnosis.
A crossed eye or strabismus is the
second most common manner in which retinoblastoma presents. The
child's eye may turn out (towards the ear), called exotropia,
or turn in (towards the nose), called esotropia.
Retinoblastoma may also present with a red,
painful eye, poor vision, inflammation of tissue surrounding the
eye, an enlarged or dilated pupil, different colored irides (heterochromia),
failure to thrive (trouble eating or drinking), extra fingers or
toes, malformed ears, or retardation. On rare occasions, retinoblastoma
is discovered on a well-baby examination. Most often, the symptoms
of retinoblastoma are first detected by a parent.