Bring eye care also under Vajpayee Scheme: Docs

The scheme covers the cost of only chemotherapy and does not provide ophthalmic care.
“The government should include ophthalmic care, too, as chemotherapy alone may not work in some patients,” said head of retinoblastoma services, Narayana Nethralaya, Dr Ashwin Mallipatna.

Retinoblastoma affects one in every 15,000 to 18,000 live births in the country. The present estimate of retinoblastoma-affected children is 1,500 new cases a year.
However, due to the lack of a national registry, the exact number is not known, said Mallipatna.

Early detection crucial

Two of the early signs of eye cancer are squint and white reflection in the eye. “There is a notion that squint eyes bring luck. But parents of children with squint eyes should take them for a test. Squints should not be ignored because while most of them are normal, others could be cases of cancer. Also, the white reflection, which is not given much attention, is almost always some eye problem,” he said.

If these signs go unnoticed, the cancer will advance and may even spread to the brain or to the bone marrow via blood, making survival unlikely, he said.
Around 15 per cent of the patients who come to Dr Mallipatna are diagnosed at an advanced stage.

“Hence, there is a need to sensitise the parents, paediatricians and health workers about retinoblastoma,” he says.

He said the government could also start centres of excellence in diagnosing and treating eye cancer at the district level, as parents of patients who came from far-off places tend to ignore follow-ups on the five-year treatment.

Gene-line cases

Many of the children suffering from retinolastoma also carry the gene, which they can pass on to their children. Termed gene-line cases, these patients also have the chance of passing on other types of cancer.

“We have a database in our hospital. However, we don’t have a genetic lab and so, sometimes, we are not able to identify gene-line cases,” said Dr P Mahesh Shanmughum, Head of the Vitreoretinal and Oncology Department, Sankara Eye Hospitals.

Mallipatna said nearly half of his patients were gene-line cases with 40 per cent of the children having both eyes affected and 20 per cent with one eye affected with tumour.