Retinoblastoma (Childhood Eye Cancer), from the CureRays guide library.

Retinoblastoma is a rare eye cancer of young children that is highly curable, with modern treatment focused on saving the child's life, the eye, and vision whenever possible.

What it is.

Retinoblastoma is a rare cancer that starts in the retina, the light-sensing layer at the back of the eye. It almost always affects young children, usually under age 5, and develops from immature retinal cells that fail to stop growing. The most common first sign is a white glow in the pupil — instead of the normal red-eye seen in flash photos, the pupil may look white or cloudy (called leukocoria); a new eye turn (crossed or wandering eye) is another common sign. Retinoblastoma can affect one eye or both. In many children it is caused by a change in a gene called RB1; when this change is inherited or present in every cell, both eyes are often involved and the child has a higher lifelong risk of other cancers, so genetic counseling is an important part of care. The reassuring news is that, especially when found early, retinoblastoma is one of the most curable childhood cancers — and modern treatment is designed not only to save the child's life but, whenever possible, to save the eye and preserve vision. Care is delivered by a specialized team of children's eye-cancer doctors.

How radiation treats it.

Radiation uses focused high-energy beams to damage the DNA inside cancer cells so they can no longer grow and divide. Retinoblastoma is sensitive to radiation, which is why radiation can be very effective at saving an eye when other treatments are not enough. Today, doctors most often reach first for focal treatments (laser, freezing) and chemotherapy, and turn to radiation in carefully chosen situations — using plaque brachytherapy, where a small radioactive disc treats the tumor directly, or proton therapy, which concentrates the dose precisely. This careful approach matters especially for children with the inherited form, who carry a higher lifelong risk of developing other cancers; modern radiation is planned to deliver the needed dose to the tumor while sparing the growing face, brain, and healthy eye tissue as much as possible. Treatments are painless, and young children may receive gentle sedation to help them stay still. The goal is always to cure the cancer first, and then to preserve the eye and vision wherever it is safe to do so. Your child's specialized team will explain whether radiation is the best choice in your situation.

The ways we can treat it.

Plaque brachytherapy. A tiny radioactive plaque is placed against the eye wall directly over the tumor, delivering a concentrated dose to the tumor over a few days while protecting nearby healthy tissue and the rest of the body.

Proton therapy. Proton beams stop precisely at the tumor, sparing surrounding tissues and lowering the radiation dose to the developing face and brain — especially important for children with inherited disease who face a higher risk of second cancers.

Stereotactic / highly focused external-beam radiation. When external-beam radiation is needed, modern precisely shaped techniques concentrate the dose on the tumor and limit exposure to healthy structures around the eye.

Questions we hear often.

Can retinoblastoma be cured? Yes. When found early, retinoblastoma is one of the most curable childhood cancers, with the large majority of children surviving. The first goal is always to cure the cancer and protect the child's life; saving the eye and vision is the next priority whenever it can be done safely.

Will my child lose the eye? Not always. Many eyes are saved today using laser, freezing, chemotherapy, and targeted radiation such as plaque brachytherapy. An eye is usually removed only when it is extensively involved or has little chance of useful vision, in which case removal can be the safest, life-saving choice — and a natural-looking artificial eye is fitted afterward.

Is retinoblastoma inherited? Sometimes. Many one-eye cases are not inherited, but disease in both eyes is almost always caused by a change in the RB1 gene that can run in families and raises the risk of other cancers later. Your team will offer genetic counseling and testing so the whole family can be cared for appropriately.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.