There is no widely accepted screening protocol for the general population.
Red reflex testing should be performed at regular intervals by a physician, starting at birth.[54]Hutchinson AK, Morse CL, Hercinovic A, et al. Pediatric eye evaluations preferred practice pattern. Ophthalmology. 2023 Mar;130(3):P222-70.
https://www.aaojournal.org/article/S0161-6420(22)00866-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/36543602?tool=bestpractice.com
Dilated fundus examinations are difficult for primary care providers to perform, and the ideal schedule and timing of such examinations is difficult to determine given that the disease can present at any time during childhood.
Screening children at high risk
The American Association of Ophthalmic Oncologists and Pathologists recommends screening children at high risk for retinoblastoma every 2 to 4 weeks for the first 8 weeks of life, followed by monthly examinations during the first year.[41]Skalet AH, Gombos DS, Gallie BL, et al. Screening children at risk for retinoblastoma: consensus report from the American Association of Ophthalmic Oncologists and Pathologists. Ophthalmology. 2018 Mar;125(3):453-8.
https://www.aaojournal.org/article/S0161-6420(17)31784-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29056300?tool=bestpractice.com
Screening may be performed in the clinic or under anesthesia. Exam under anesthesia may be preferred for high risk children ages >8 weeks.[41]Skalet AH, Gombos DS, Gallie BL, et al. Screening children at risk for retinoblastoma: consensus report from the American Association of Ophthalmic Oncologists and Pathologists. Ophthalmology. 2018 Mar;125(3):453-8.
https://www.aaojournal.org/article/S0161-6420(17)31784-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29056300?tool=bestpractice.com
A noninvasive prenatal diagnosis test has been developed and evaluated for retinoblastoma.[55]Gerrish A, Bowns B, Mashayamombe-Wolfgarten C, et al. Non-invasive prenatal diagnosis of retinoblastoma inheritance by combined targeted sequencing strategies. J Clin Med. 2020 Oct 30;9(11):3517.
https://www.mdpi.com/2077-0383/9/11/3517
http://www.ncbi.nlm.nih.gov/pubmed/33143217?tool=bestpractice.com
However, little experience of its use exists, and clinical screening remains the gold standard.