Factors Associated with Delayed Presentation of Retinoblastoma at Tertiary Centres in South West Nigeria

Retinoblastoma is the most common primary intraocular malignancy in children, and survival rates as well as globe salvage outcomes are significantly influenced by the timing of presentation. Delayed presentation remains a major challenge in Nigeria, resulting in high rates of enucleation and mortality. This study investigates the factors associated with delayed presentation of retinoblastoma at tertiary eye care centres in Lagos, Ibadan, and Ile-Ife, South West Nigeria. A retrospective case-series design with prospective data collection will be employed, reviewing records of 120 retinoblastoma cases over five years. Delay will be measured from first symptom recognition to tertiary hospital presentation. Independent variables will include rural versus urban residence, parental education, healthcare-seeking pathway, prior use of traditional medicine, and family awareness of childhood cancer. Binary logistic regression will identify independent predictors of delayed presentation. The study anticipates that rural residence, low parental education, prior traditional medicine use, and initial presentation to non-specialist facilities will be the strongest predictors of delay. Findings will be submitted to the Nigerian Children's Cancer Foundation and the Federal Ministry of Health to guide awareness campaigns and referral pathway improvements. This research fills a critical evidence gap in pediatric ocular oncology in South West Nigeria and provides actionable recommendations for reducing diagnostic delay in retinoblastoma. Keywords: retinoblastoma, delayed presentation, children, South West Nigeria, ocular oncology