Does Retinoblastoma Cause Blindness? Risks, Symptoms, and Treatments Explained

Retinoblastoma, a rare eye cancer, can cause blindness or worse if untreated. Early detection and treatment are crucial for preserving vision and life.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Sep 25, 2025

Retinoblastoma, a rare eye cancer, can cause blindness or worse if untreated. Early detection and treatment are crucial for preserving vision and life.

Retinoblastoma is a rare eye cancer that primarily affects children and can lead to blindness or even death without timely intervention. Early recognition, diagnosis, and treatment are critical to preserving vision and preventing life-threatening complications. This comprehensive guide explores the risk of blindness from retinoblastoma, other key symptoms, causes, treatment options, and what families should know to protect their child’s sight and health.

Overview: What Is Retinoblastoma?

Retinoblastoma is a rare and aggressive cancer that forms in the retina—the light-sensitive tissue at the back of the eye responsible for converting light into electrical signals sent to the brain. The disease most commonly affects young children under age five, but can occasionally occur in older children and adults.¹

To better understand the threats to a child's vision and how timely intervention can mitigate risks, explore our detailed guide on the 7 Major Causes of Blindness. This resource highlights critical information that can empower families to act swiftly and decisively in protecting their child's sight.

Approximately 8,000 children worldwide are diagnosed with retinoblastoma each year.¹
It can develop in one eye (unilateral) or both eyes (bilateral).
Early intervention is crucial for both life and vision preservation.

Can Retinoblastoma Cause Blindness?

Yes, retinoblastoma can cause partial or complete blindness if left untreated or if the tumor is large and located in critical areas of the retina.¹ The risk and degree of blindness depends on several factors:

Whether the cancer is in one or both eyes.
The size and location of the tumor within the retina.
The promptness and effectiveness of treatment.
Whether treatments, such as surgery or therapy, result in removal or damage to critical eye structures.

Understanding the various forms of tumors that may affect the eyes is crucial for effective management and intervention. Delve into our in-depth overview of Tumors in the Eye to gain insights into types, symptoms, and the best treatment approaches that can safeguard vision.

According to studies:

Bilateral retinoblastoma (affecting both eyes) carries a significantly higher risk of blindness.
One study of children with bilateral retinoblastoma found that visual impairment occurred in 38% and blindness in 19%.³
Unilateral retinoblastoma generally does not lead to complete blindness because the unaffected eye can usually compensate.³

How Retinoblastoma Leads to Blindness

As cancerous cells proliferate, tumors enlarge and disrupt the retina’s ability to process light.
If unchecked, cancer can invade the optic nerve or other structures, permanently impairing vision.
Tumors may also cause an increase in eye pressure (secondary glaucoma) or retinal detachment, both of which can cause profound vision loss.
Some treatments (laser therapy, radiation, or enucleation—removal of the eye) can also result in blindness, especially when other options have failed or multiple tumors are present.^1,2

When facing a diagnosis of retinoblastoma, understanding the broader context of related eye conditions can significantly inform treatment decisions. Check out our comprehensive guide on Retinal Diseases to identify symptoms and explore treatment options that may affect long-term vision outcomes.

Discussing the potential impact of each treatment on vision with a healthcare provider is essential for informed decision-making.

Signs and Symptoms of Retinoblastoma

Recognizing early signs of retinoblastoma is critical for timely diagnosis and treatment. Symptoms can be subtle, especially in infants, so awareness is key:

Leukocoria: A white reflection in the pupil, noticeable in flash photographs or when light shines in the eye.
Strabismus: Misalignment or crossing of the eyes.
Reduced or poor vision in one or both eyes.
Redness and swelling of the eye without infection.
Bleeding in the front part of the eye.
Pain in the affected eye (occasionally).
Enlargement of the eyeball (may indicate advanced disease).

It's vital to recognize underlying eye conditions that can present similarly to retinoblastoma. Educate yourself on the signs by visiting our detailed resource on Retinal Bleeding, which outlines critical symptoms that require prompt attention to avoid severe consequences.

These symptoms do not confirm retinoblastoma, but should prompt an immediate evaluation by a pediatric ophthalmologist or eye specialist.

What Causes Retinoblastoma?

Retinoblastoma results from genetic mutations that cause unchecked growth of retinal cells. The disease can occur in two primary forms:

Hereditary Retinoblastoma: Accounts for about 40% of cases; caused by inherited mutations in the RB1 gene. Can affect one or both eyes and is more likely to involve multiple tumors.³
Non-Hereditary (Sporadic) Retinoblastoma: Represents about 60% of cases; caused by spontaneous or unknown mutations. Usually affects only one eye and typically presents as a single tumor.³

Children with hereditary retinoblastoma have a higher long-term risk for other cancers because the genetic mutation may be present throughout the body.

Risk Factors

Family history of retinoblastoma or a parent carrying an RB1 gene mutation.
Specific genetic syndromes or known mutations.
Children under five years of age are most at risk.

Diagnosing Retinoblastoma

Early and accurate diagnosis is vital for preserving sight and life. Diagnostic steps may include:

Comprehensive dilated eye exam by an ophthalmologist.
Imaging studies such as ultrasound, MRI, or CT scans to assess tumor size, number, and location.
Genetic testing for RB1 gene mutations, especially in families with a history of retinoblastoma.
Systemic evaluation to rule out spread to other body parts, especially the brain.

Treatments for Retinoblastoma

The main aim of treatment is to eliminate the tumor while preserving as much vision and eye structure as possible. Treatment strategies depend on:

The size, number, and location of tumors
Whether cancer is in one or both eyes
Vision status in each eye
Whether the cancer has spread elsewhere in the body

Chemotherapy

Systemic chemotherapy uses medications to shrink tumors throughout the body, often as a first-line approach, especially for large, multiple, or bilateral tumors.^2,4

Intravenous (IV) chemotherapy: Drugs are delivered through a vein, allowing the medication to process through the entire body, including both eyes if necessary.²
Intra-arterial chemotherapy: Delivers medication directly into the artery supplying the eye, allowing for high local concentrations with fewer systemic side effects.^2,4
Intravitreal chemotherapy: Medication is injected directly into the eye, often in combination with other methods when tumor cells are floating within the eye.²

Focal Therapies

Laser therapy (Transpupillary thermotherapy): Uses focused heat from a laser to destroy small tumors at the back of the eye.⁵
Cryotherapy: Destroys tumors near the front of the eye using extreme cold.⁵
Both methods are often repeated multiple times to ensure tumor eradication.

Other Treatment Options

Radiation therapy: Less common today, especially due to risks to developing tissues, but sometimes used when other methods fail.
Enucleation: Surgical removal of the eye may be necessary for large tumors or those unresponsive to other treatments. Immediate placement of an ocular implant helps reduce cosmetic impact.^1,2

Impact of Treatment on Vision

Some retinoblastoma treatments carry a risk of permanent vision loss or blindness:

Laser and cryotherapy may cause scarring inside the eye, reducing vision.
Enucleation eliminates all vision in the affected eye.
Radiation and chemotherapy can also affect developing eye structures, particularly in young children.
Efforts are made to preserve the unaffected or better-seeing eye whenever possible.

Living with Retinoblastoma: Outcomes and Follow-Up

Survival rates for those treated for retinoblastoma are high in countries with advanced medical systems. However, long-term quality of life depends on:

How much vision (if any) was preserved in one or both eyes.
Potential need for prosthetic eyes or visual aids.
Regular surveillance for tumor recurrence or later-life secondary cancers, especially if RB1 mutations are involved.
Psychosocial support for blindness or visual impairment can be crucial for development and quality of life.

Vision Adaptation and Support

Children who lose one eye typically adapt well and retain good vision in the other eye. Activities and development can continue with proper support.
Those with blindness in both eyes benefit from early vision rehabilitation, orientation and mobility training, and specialized educational resources.
Ongoing family support and counseling help manage fears, expectations, and emotional impact.

Can Retinoblastoma or Blindness Be Prevented?

No guaranteed preventive measures exist for retinoblastoma because most cases are due to spontaneous mutations. However, children with a family history of the disease should be:

Screened for RB1 gene mutations early in life.
Scheduled for regular eye exams by trained specialists, even when there are no symptoms.
Monitored closely if a parent or sibling had retinoblastoma, as early-stage tumors may be more treatable and vision-sparing.

Key Takeaways

Untreated retinoblastoma almost always leads to vision loss, blindness, or death.
Early diagnosis and advances in therapy can cure the cancer and, in many cases, preserve sight.
Treatment may result in partial or total vision loss in one or both eyes, but life can be saved, and adaptation is possible.
Genetic counseling, regular screenings, and awareness of early symptoms are vital for families at risk.

Frequently Asked Questions (FAQs)

Q: What long-term problems can children with retinoblastoma face after treatment?

A: Survivors may deal with partial or total vision loss, need for prosthetic eyes, and regular monitoring for recurrence or secondary cancers, especially in hereditary cases.

Q: If one eye is removed, will my child have normal vision?

A: Children typically adapt well after losing one eye, as the remaining eye can often compensate. Some depth perception issues can persist, but most children lead active and productive lives.

Q: Can adults develop retinoblastoma?

A: While retinoblastoma is most common in children under five, it can rarely affect older children or adults.

Q: Are all cases of retinoblastoma inherited?

A: No. About 40% of cases are hereditary; the majority are caused by non-inherited, spontaneous genetic mutations.

Q: Can early treatment prevent blindness from retinoblastoma?

A: Yes, early detection and prompt, appropriate treatment greatly reduce the risk of blindness and can sometimes preserve normal or near-normal vision, especially in unilateral cases.

References: This article is based on current evidence and clinical resources including Healthline, the National Eye Institute, UCSF Benioff Children’s Hospitals, and Medical News Today.

References

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete