Early warning signs of childhood eye cancer that parents often miss

Unfortunately, because childhood eye cancer symptoms are painless and children cannot clearly express vision problems, the diagnosis is often delayed. This delay can significantly impact both vision preservation and survival outcomes.

Childhood eye cancer, most commonly retinoblastoma, often presents with subtle early signs that parents may overlook or dismiss as nothing of significance. One of the earliest and most critical warning signs is a white reflection in the child’s eye, especially noticeable in photographs taken with flash. Persistent squinting, crossed eyes, or an eye that appears misaligned are other warning signs that should also never be ignored. In some cases, parents may notice redness, swelling, or watering of the eye that does not improve with routine treatment. 

Another concerning sign is a noticeable change in vision, which, when compromised, might lead children to bump into objects, struggle to focus, or show reduced interest in visual activities. Unfortunately, because these symptoms are painless and children cannot clearly express vision problems, the diagnosis is often delayed. This delay can significantly impact both vision preservation and survival outcomes. 

Fairooz P Manjandavida, Specialist, Ocular Oncology, HORUS Specialty Eye Care, Bengaluru, says, "Early detection of childhood eye cancer can be life-saving. Regular eye screenings in infancy and early childhood, along with prompt evaluation of any unusual eye appearance or behaviour, are crucial. Implement newborn red reflex screening, dilated exams through age 5 (essential for 40% hereditary cases), and immediate ophthalmology referral for any anomaly. Parents should stay vigilant, if something about their child’s eyes seems unusual, seeking immediate specialist consultation can make all the difference."

Dr Manish Sahni, Consultant Surgical Oncologist, Kailash Hospital, Noida, says, "Eye cancer in children is rare but can be serious if not detected early. Parents often overlook the subtle warning signs. One of the most noticeable signs is a white reflection in the pupil (cat’s eye reflex). Other signs include redness or swelling in the eye, crossed eyes, poor vision, frequent squinting, or a child complaining of eye pain. Changes in eye alignment or unusual eye movements may also be a warning."

Early detection makes treatment more effective and increases the chances of protecting the child’s vision. Being aware of early signs, maintaining regular eye exams, and promoting a healthy lifestyle can make a big difference. Early attention and preventive care are key to keeping a child’s eyes healthy and ensuring their overall well-being.