Management of orbital retinoblastoma; Kenyatta national hospital experience
Approximately 30-40% of retinoblastoma patients Sub-Saharan Africa have orbital disease at presentation. This presents the ophthalmologist with several challenges among them if to do a primary excentaration or not, if to aim at cure or palliation and which adjuvant therapy to give. At Kenyatta National Hospital, Protocol based management of retinoblastoma developed by the Kenya National Retinoblastoma society has been used to manage these cases with promising success in terms of survival and cosmesis. All retinoblastoma cases with orbital disease are evaluated for distant metastases and if free, then aim to cure treatment started with Chemoreduction. After the proptosis reduces, enucleation with primary orbital implant is done. Chemotherapy is then continued to a total of six courses then radiotherapy upto 40 Grays.