The Big See

At a Glance

• Approaches for diagnosing and treating pediatric and adult intraocular and ocular surface tumors differ, but advanced techniques are increasingly being used for both patient groups

• Treatment approaches include brachytherapy, proton beam radiotherapy, photodynamic therapy (PDT), and chemotherapy depending on the type, size and location of the tumor

• For pediatric retinoblastoma, local cryotherapy or laser treatment and brachytherapy plaques can be used for smaller tumors; chemotherapy approaches are used for more advanced cases, given systemically, into the ophthalmic artery or vitreous cavity.

• Application of virtual clinics and artificial intelligence has the potential to pick up suspicious lesions at an earlier stage – and to make the referral process much more streamlined.

The eye can develop a range of primary or secondary tumors: some are more common in adults, while others are more typical of children. We therefore adopt somewhat different investigational approaches for the pediatric and adult populations; in both groups of patients, taking a detailed medical and ophthalmic history, performing a thorough examination and using imaging are key to correct diagnosis and management. These patients are best managed as part of a multi-disciplinary team of professionals.