Madurai: Five-year-old Divakar, son of a farmhand in a Madurai village, would not be playing with his two-year-old sister today had he not been treated for retinoblastoma (RB), a rare malignant tumour of the retina affecting young children. Besides saving his life, a genetic analysis done soon after his mother became pregnant with the girl saved the life and vision of Divakar’s sister too.
Divakar is one of the many children treated for RB at Orbit and Oculoplasty Clinic of Aravind Eye Hospital here. The clinic has come a long way since 1992, when it started to treat eye cancer either through removal of the eye ball and its replacement with a prosthetic eye or recommending a patient for chemotherapy. With the recent opening of Ocular Cancer Genetic Centre at the hospital, it is now possible to diagnose predisposition for eye cancer and prevent its incidence among children.
“After providing treatment, prosthetic eye and rehabilitation for patients for years, the question of what we could do to prevent RB kept haunting us. Collaborative research with Dr. G. Venkataswamy Eye Research Institute threw up a pattern among our patients. If we are able to see the tumour early, we can save the life of the child. But if we find out the predisposition to RB from gene mutation in either of the parents, we can save both vision and life of the child,” says Usha Kim, chief, Orbit, Oculoplasty and Oncology Clinic.
According to her, five patients visit Aravind Eye Hospital with RB every week. In some cases, RB manifests in more than one member of the family. There have been instances of a child having RB in both the eyes.
“If there is gene mutation in either of the parents, there is possibility of intra-ocular tumour in the child. RB is noticed between 18 months to three years and hence awareness of it should be more among peripheral doctors and ophthalmologists. Like in many developing nations, eye check-up immediately after birth should be mandatory,” says VR. Muthukaruppan, former Vice-Chancellor, Bharathidasan University, and Advisor-Research, Dr. G. Venkataswamy Eye Research Institute.
Any difficulty in vision or white reflections or squint eye should be immediately referred to an ophthalmologist. “Absolute vision salvation is possible if treated early,” says Dr. Usha.
Dr. Muthukaruppan says the chromosome responsible for RB is very complex and it normally takes six weeks to identify the mutation. Though Tamil Nadu is not a hot spot for RB, new mutations are being found, which warrant development of new methods of treatment. Aravind Eye Hospital provides free treatment for eye cancer for poor patients, with ‘Ring of Hope Fund’. Dr. Usha is confident that the methodology adopted at the hospital can be replicated in underdeveloped and developing nations.
