Frequently in bilateral cases, the more severely affected eye was removed. More recently chemotherapy has been used to achieve reduction of local tumors so that a more conservative treatment would be possible for definitive tumor control. Currently the treatment modalities that we advocate include enucleation, external beam irradiation, brachytherapy, photocoagulation, cryotherapy, chemotherapy, chemothermotherapy and chemoreduction. With the use of chemotherapy some eyes are being saved that would have been enucleated only 5 years ago. Today, a child who develops retinoblastoma may retain relatively normal levels of vision in many cases.
Prognosis is still in part dependent on early recognition.
All physicians who see small children are aware that prompt referral for any child who has a suggestion of a white pupillary reflex or new onset of strabismus is critical. Although retinoblastoma is a malignant tumor, it can be successfully treated in many cases if early, accurate diagnosis and prompt referral are made. Clinical and pathologic features. Incidence of second neoplasms in patients with bilateral retinoblastoma. Shields CL, Shields JA, Minelli S, et al.