The tissue that lines the inside of the back of your eye, called the retina, contains light-sensitive cells that work with the rest of your eye to provide vision. In some children, cancer cells may form a tumor in these cells, a condition known as retinoblastoma. If retinoblastoma occurs in both eyes and in a location within the brain, such as the pineal gland, this results in trilateral retinoblastoma. Due to the connection between the retina and the pineal gland, trilateral retinoblastoma could result in low melatonin levels.
Symptoms
Retinoblastoma typically appears in early childhood. You may notice your child has an unusually shaped pupil or that his pupil appears white. Other signs of this condition may include poor vision, crossed eyes and redness on the white of the eye. Your child may also experience eye pain. Other symptoms can occurs as well, but these depend on the location of the third intracranial tumor. If the tumor occurs in the pineal gland that produces melatonin, your child may have a droopy eyelid, eye swelling, nausea and swelling in the brain. If the tumor occurs in other locations of the brain he may have headaches, poor balance, change in personality, seizures or difficulty talking.
Melatonin
The pineal gland produces the hormone melatonin, which regulates the body’s circadian rhythm, the internal “clock” that tells us to when to sleep and when to stay awake. After dark, the pineal gland produces more melatonin to encourage sleep, while it produces less of this hormone during the day to promote wakefulness. Cells within the retina, retinal ganglion cells, play an important role in regulating melatonin levels. Damage to these cells from retinoblastoma could result in low melatonin levels. As well, if the third intracranial tumor appears in the pineal gland, this may also affect melatonin production. Low levels could result in difficulty sleeping.
Treatment
If your child has difficulty sleeping due to low melatonin levels, his doctor may recommend melatonin supplements. Depending on the severity of the tumors, your child’s eye specialist may recommend a number of treatment options. These options may include radiation and chemotherapy, but if he has large retinal tumors, the doctor may recommend removing one or both eyes to prevent the cancer from spreading. For brain tumors and tumors of the pineal gland, the treatments will depend on the location and extensiveness of the tumor. Your child may require radiation, chemotherapy or surgery.
Considerations
Retinoblastoma has a hereditary factor, so if anyone in your family had retinoblastoma, take your child for eye examinations regularly. If you notice changes in the appearance of your child’s eyes, contact an eye doctor. Early detection may help prevent serious complications.
References
- National Cancer Institute: General Information About Retinoblastoma
- University of Maryland Medical Center; Melatonin; Steven D. Ehrlich, NMD
- “Eye”; Light, Dark, and Melatonin: Emerging Evidence for the Importance of Melatonin in Ocular Physiology”; R. Brennan, et al.; March 2006
- PubMed Health: Retinoblastoma
- Cedars-Sinai: Pineal Tumors
- MayoClinic.com; Brain Tumor; May 2010
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