Detecting Eye Cancer in Children

You know the saying, “It’s rare until it happens to you.” Well, if it does happen, your life is turned upside down and you do all that you can to fix it. NPR recently wrote an article about a young chemist named Bryan Shaw whose son was diagnosed with a rare form of eye cancer, retinoblastoma. This can often present itself as a white pupil reflection called leukocoria, especially noticeable in photos. What he found remarkable was that the white reflex was present in photos of his son as early as 12 days old. The father has now switched careers to develop a software program that would automatically recognize leukocoria in photos and to alert users to have this examined.

Photo Courtesy of Bryan Shaw

Photo Courtesy of Bryan Shaw

It’s an interesting concept, ingenious really. How many eyes and lives can be saved this way? If even one is saved, then it is worth it. I hope to see this software developed and implemented soon. But in the meantime, should we all start scouring through photos of our kids? That’s not a bad idea, but there may be a better solution.

Over a decade ago, President Carter approached the American Optometric Association about developing a program to detect eye diseases and conditions in children at no cost. This was after discovering that two of his grandchildren suffered from amblyopia or lazy eye, which if detected early could have been prevented or treated effectively. From there, the American Optometric Association developed a public health program called InfantSee.

InfantSee provides an infant eye assessment between 6 and 12 months of age as a no-cost public service. Doctors across the nation donate their time to examine infants in their practice settings. The assessment allows us to screen for excessive amounts of nearsightedness, farsightedness, and astigmatism, check eye teaming and movement ability, and detect eye diseases including retinoblastoma.

Courtesy of PhotoFlurry on Flickr

Courtesy of PhotoFlurry on Flickr

For almost a decade, I have been examining infants in my office through referrals from pediatricians to the InfantSee program. The majority of the infants are fine. I have come across a couple with a high prescription or an eye turn that requires monitoring. I have found a cataract in an infant who eventually underwent cataract surgery as a child in order to maintain good vision. I haven’t seen a retinoblastoma yet and hope to never tell a parent I see one in her child’s eye.

I look forward to seeing if Bryan Shaw’s software is created and used routinely on Instagram or Facebook. But even then, I still want to see the infants in my exam chair because I’m checking for more than a white pupil.


Cindy P. Wang, OD, FAAO

California Optometric Association



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