The primary goal in treatment of retinoblastoma is to ensure tumor regression and to improve survival. The secondary goals are to preserve the eye and to maximize vision. The 5-year survival rate after treatment for retinoblastoma has improved to 97% in developed countries and the rate of enucleation has decreased significantly, especially for bilateral retinoblastoma. With this improved survival, it has become critical to monitor the visual acuity results after treatment and also to consider interventions to improve long-term visual acuity. Visual rehabilitation with amblyopia therapy is of high importance to maximize visual function in retinoblastoma patients. Cataract surgery with implantation of intraocular lens is a safe procedure in patients with regressed quiescent tumors. Posterior segment procedures are reserved for monocular patients and have a higher risk of extraocular tumor spread.