My little girl was diagnosed with eye cancer – the warning sign was worryingly subtle

A mother has revealed the disturbingly subtle sign that her then 14-month-old daughter had eye cancer.

Isla Palul’s moms, Rebecca and Charlotte Palul, noticed her eye moving strangely while playing with toys during Christmas 2020.

Concerned that her eye appeared to be ‘buzzing’, the mothers, from South London’s Putney, called their GP.

In January 2021, after weeks of testing, doctors diagnosed Isla, now three years old, with retinoblastoma in her right eye – a rare and aggressive form of eye cancer.

Isla has now undergone chemotherapy, which has “done its job” and shrunk the tumor. However, the toddler is still receiving treatment to control it and has impaired vision.

Her parents, who also have a five-month-old son, Theo, have been warning others about the symptoms to watch out for since their daughter’s ordeal.

Rebecca, 35, said: ‘I remember playing on the floor with Isla, and she looked at a toy and then looked up at me.

“When she looked up, her right eye flitted side to side and back as if it couldn’t focus.”

Rebecca said she and her wife would notice Isla’s eye “wiggling at times,” but they assumed she had a lazy eye and might need glasses.

They had a telephone appointment with a GP between Christmas and New Year due to the lockdown and were referred to the children’s clinic at St George’s Hospital in Tooting.

During the appointment, which 36-year-old Charlotte was not allowed to enter due to Covid rules, the doctor performed a red reflex test – an examination of pupillary reflections that can help identify eye abnormalities.

The medic referred Isla to the hospital’s eye clinic.

During this appointment, Isla’s left eye was covered so that the movements of her right eye could be examined.

Rebecca said her right eye, which was dilated, “couldn’t focus anything and was going all over the place.”

The doctor then told her that there was a tumor in Isla’s eye, leaving Rebecca ‘blinded’.

She said, “I cried and Isla looked at me perfectly happy and probably wondered what was going on.”

Each year, about 40 to 50 young people in the UK and 200 to 300 in the US are diagnosed with retinoblastoma, which typically affects infants and children under the age of six.

Retinoblastoma occurs when retinal eye cells — which are supposed to grow very quickly and then stop growing during a baby’s early development — continue to grow and form cancer.

When the tumor forms, light reflects off the white surface of the cancer, causing the child’s dilated pupil to appear white in flash photos or in low-light conditions.

Symptoms include an unusual white reflection in the pupil, strabismus, a red or inflamed eye, and poor vision.

About 98 percent of children survive retinoblastoma.

But the Childhood Eye Cancer Trust (CHECT) says early detection is crucial to saving sight and life.

But Rebecca cautioned that the most common symptom of retinoblastoma wasn’t noticed until a photo of Isla was taken with flash after diagnosis: a white “glow” in the eye.

A retinoblastoma clinical nurse specialist from the Royal London Hospital called the family on the night of her diagnosis to inform them that Isla would be seen the following week.

Six days later, on January 28, 2021, the tumor was confirmed at the Royal London Hospital as stage D retinoblastoma.

Doctors believed Isla’s eye could be saved because they told the family it was a small stage D tumor.

The toddler first underwent a lumbar puncture — a thin needle inserted between the bones in the lower back to take a sample of fluid — and an MRI to make sure the cancer hadn’t spread.

She then had a port placed in her chest to administer chemotherapy and take blood samples.

She began the first of six rounds of chemotherapy on February 5, 2021, contracting multiple infections during that time that resulted in several hospitalizations – one of which was at Great Ormond Street Hospital.

Fortunately, the chemo has ‘done its job’, says Rebecca, and Isla’s tumor has shrunk.

But Rebecca said that although the tumor is stable now, “tiny tumor seeds” are growing in her eye. As a result, she needs cryotherapy – the use of extreme cold to freeze and remove abnormal tissue – to control the cancer.

Rebecca said Isla remained happy and smiling throughout her treatment and battled through chemotherapy “like a little trooper.”

And in 2022 she even received a CHECT Champion award for her bravery.

Isla now has reduced vision in her right eye and sometimes has trouble walking down stairs or keeping her balance.

Richard Ashton, CEO of CHECT said: ‘Symptoms (of retinoblastoma) can be quite subtle, and children often appear to be fine, which can make it difficult to diagnose. In just under half of all cases, a child has to have an eye removed as part of the treatment.’

He added that an urgent referral was to say thank you this was not the case for Isla, and urged other parents who notice symptoms to have their children seen by a health professional as soon as possible.