For clinicians | Early detection of retinoblastoma
Early detection of retinoblastoma
The earliest method of detection of retinoblastoma is by red reflex assessment. To assist GPs and health visitors with this assessment we, along with The Childhood Eye Cancer Trust, have developed the guide below. This will help to facilitate the transfer of patients directly into a paediatric ophthalmology clinic.
The red reflex is an extremely important method of assessing children's eyes. It is a non-invasive test and should be used at all assessments.
Method
Sit in front of the child and parent at about arm's length. Set the ophthalmoscope to around +2 (green or black). First of all, focus on the parent's eyes to show that the test is non-invasive and to show the normal red reflex in their ethnic group. Next focus on the child's face and encourage them to look at the light. Focus on the red reflex within the pupil.
Outcomes
The images below show the possible outcomes. You can show these images to parents as they may have taken photographs demonstrating usual red reflexes.
Normal red reflex = no referral
Red reflex absent
Obvious +/- asymmetry = urgent referral
Unsure/difficult assessment = Paediatric Ophthalmology Primary Care Clinic referral
Red reflex abnormal = urgent referral
Referrals
Please refer suspected retinoblastoma patients to:
Mr Ashwin Reddy
Consultant Paediatric Ophthalmologist and Retinoblastoma Surgeon
Department of Ophthalmology
Royal London Hospital
Whitechapel
London
E1 1BB
Tel: 020 7377 7426
Fax: 020 7377 7112
Red reflex poster
The attached poster has been produced by Barts and The London NHS Trust with assistance from the Childhood Eye Cancer Trust and Birmingham Children’s Hospital. The Childhood Eye Cancer Trust is a registered UK charitable organisation dedicated to support families with retinoblastoma.
Download red reflex poster.
