retinoblastoma

hello, we had our 3 and 5 year old for two eye exams within the last year.  i know that they only need one a year, but i am a hypochondriac!  anyways, i was researching about retinoblastoma and the cats eye (white reflex) that this disease can show in pictures.  we had gotten some pics back that in some of the photos, the eye or eyes of my kids (and even me in one) the eye was not a really red reflection that you can get in some photos.  almost looked light pink.  so we brought the kids in for an eye exam (pupils were dilated for the exam) and the eye dr. gave both a very thorough checkup.  all was fine.  this was 6 months ago.  the kids are now 4 and 6.  they both recently passed a school vision test given by the nurse.  
we had some photos taken w/digital camera (a couple of people were flashing their cameras at the same time for a family photo) and on two of the email i got with  the pictures, the small picture (jpeg) looked like the one child had a white reflex, BUT when i click to enlarge the photo, the reflex was normal!!!  can the white reflex sometimes show from other flashes/lighting?  or the optic nerve or something being hit at just the right angle?  plus, they had dilated exams and checked by the ped. often, so would retinoblastoma be very unlikely?  i hear there are only 300 cases in the U.S. per year.  any info. would be great.  thanks!

[John C Hagan]

Generally retinoblastoma is present from birth and a previously normal exam with dilation makes it highly unlikely that either child would have one that would just now show up.  Yes it is possible for several reasons to have a white reflex that is not a retinoblastoma.  Most all the worrisom things would have shown up in the earlier exam. I would say its just the reflections.

JCH III MD

[ny2125]

thanks for the reply.  one other thing, does a child/person w/retinoblastoma see with the infected eye at all?  and, wouldnt an ultrasound close to birth maybe reveal a tumor in the eye or eye area?  thanks again.

[John C Hagan III, MD, FACS, FAAO]

The retina blastoma  affects the eye, it does not "infect the eye". There is no infection, its a tumor.  In a small retinoblastoma located far from the macula the vision in the eye may be normal. In a huge tumor that fills all the eye the eye may be blind.

The standard fetal ultrasound done on pregnant women is probably not sensitive enough to pick up anything but the hugest tumor filled eye.

JCH III MD