Signs and Symptoms of Retinoblastoma

Retinoblastomas nearly always occur in young children. They are often found when a parent or doctor notices that a child’s eye looks unusual.

White pupillary reflex

This is the most common early sign of retinoblastoma. Normally when you shine a light in the eye, the pupil (the dark spot in the center of the eye) looks red because of the blood vessels in the back of the eye. In an eye with retinoblastoma, the pupil often appears white or pink instead, which is known as a white pupillary reflex (or leukocoria).

A parent might notice this white glare after a flash photograph is taken, especially if the pupils are different colors. It also might be noted by the child’s doctor during a routine eye exam.

Lazy eye

Sometimes the eyes don’t appear to look in the same direction, a condition often called lazy eye. (Doctors call this strabismus.) There are many possible causes of this in children. Most of the time lazy eye is caused by a mild weakness of the muscles that control the eyes, but it can also be caused by retinoblastoma.

Other possible signs and symptoms

Less common signs and symptoms of retinoblastoma include:

  • Vision problems
  • Eye pain
  • Redness of the white part of the eye
  • Bleeding in the front part of the eye
  • Bulging of the eye
  • A pupil that doesn’t get smaller when exposed to bright light
  • A different color in each iris (the colored part of the eye)

If the cancer spreads outside the eye, symptoms depend on where the cancer is. Some possible symptoms include:

  • Loss of appetite and weight loss
  • Headache
  • Vomiting
  • Lumps under the skin in the neck

Many of these signs and symptoms are more likely to be caused by something other than retinoblastoma. Still, if your child has any of these, check with your child’s doctor so the cause can be found and treated, if needed.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Hurwitz RL, Shields CL, Shields JA, et al. Chapter 27: Retinoblastoma. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2016.

Kaufman PL, Kim J, Berry JL. Retinoblastoma: Clinical presentation, evaluation, and diagnosis. UpToDate. Accessed at www.uptodate.com/contents/retinoblastoma-clinical-presentation-evaluation-and-diagnosis on September 18, 2018.

National Cancer Institute. Retinoblastoma Treatment (PDQ®). 2018. Accessed at www.cancer.gov/types/retinoblastoma/hp/retinoblastoma-treatment-pdq on September 18, 2018.

Rodriguez-Galindo C, Orbach DB, VanderVeen D. Retinoblastoma. Pediatr Clin North Am. 2015;62(1):201-223.

Last Medical Review: December 3, 2018 Last Revised: December 3, 2018

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