Retinoblastoma and School Activities
Being able to embrace all possible school activities is important to every child’s complete wellbeing.
Children should not be excluded from classroom, playground or physical education activities unless a doctor instructs this.
Group work and play develops confidence, social skills and a sense of belonging, and should be actively encouraged.
Supporting a child with cancer and / or limited vision in the classroom, playground and sports activities is vital to ensure they feel welcome, involved and respected.
Children with impaired vision may need to sit so they don’t have to turn awkwardly to see. For example, a child who sees with only the right eye may need to sit to the left of the room to accommodate the loss of left visual field. Poor seating can result in headaches and neck pain and loss of interest in school activities.
Some children only have to turn slightly, but many may need to move to a completely different seat. Older children learn to find appropriate places to observe and participate. Younger children may need more support.
Children treated with radiotherapy may be very sensitive to bright sun and artificial light. Wearing sunglasses or a peaked / wide brim hat on sunny days can reduce discomfort and ensure the child remains fully engaged in activities.
If vision in both eyes is impaired, your child may need to sit near the front of the classroom, and being able to hear the teacher clearly will be vital. Straining to see and hear will affect her posture and enthusiasm for school. The resulting tension may cause headaches and muscle pain.
During chemotherapy, or immediately after enucleation, certain activities may be restricted. When the oncologist and ophthalmologist give the OK, your child can swim and do sports as usual.
Depending on the degree of vision loss, your child may need help with hand-eye co-ordination activities like ball games. Children adapt well, but these difficulties can affect confidence, so sensitivity is essential, especially when assisting the child in the presence of classmates.
Encourage your child to wear protective glasses during sports that risk eye injury. Ask the teacher to ensure she wears them, and suggest they be promoted to other families so your child does not feel different, and so other children have extra protection too.
Water Play and Swimming
Your child should not swim until her ophthalmologist gives the OK after enucleation surgery. Swimming risks infection of the eye socket before the surgical wound has completely healed.
If your child has an external venous catheter (hickman, broviac or “wiggly”), she will not be allowed to swim. The external line must be kept dry to prevent infection. Children who have a port-a-cath (under the skin) can swim, but some doctors prefer they avoid swimming due to potential infection risk.
Water play can be very therapeutic, and is fine so long as it does not cause the external line to become wet. Ensure your child’s teacher checks the line is fully waterproofed before and after water play activities.
Minimum fuss is very important if your child is not able to participate in an activity. Ask the teacher to provide a fun alternative and involve other children in it. This will support your child’s emotional wellbeing and reduce the risk of her feeling different or inferior to her classmates.