K K EYE Institute

RETINOPATHY OF PREMATURITY

What is Retinopathy of Prematurity (ROP)?

The membrane inside the eye (the retina) is not fully developed in a premature baby due to early birth. During development of the foetus the blood vessels grow from the central part of the eye outward, towards the edges. This process is completed just a few weeks before the normal time of delivery. In premature babies this process is not complete due to their premature birth. After premature birth if the blood vessel growth proceeds normally, the baby does not develop any problems. If the vessels grow and branch abnormally the baby develops a retinal problem called ROP (Retinopathy of Prematurity). It is most common in babies who are born more than 12 weeks premature. This abnormal growth of blood vessels can cause bleeding inside the eye and even progress to retinal detachment. The result is irreversible low vision or blindness.

How can we detect ROP?

A trained ophthalmologist (retina specialist) can detect ROP by dilating the eye (Dilating means instilling eye drops to make the pupil bigger in order to get a better view of the inside of the eye) and using an indirect ophthalmoscope to scan the entire retina to detect ROP and gauge the state of retinal maturity.

Do all babies need a retinal examination for ROP?

All preterm babies must undergo a retinal examination. Babies with a birth weight of less than 1700 gm or those born less than 35 weeks of pregnancy are most likely to have ROP. Any other preterm baby who has had problems after birth (lack of oxygen / infection / blood transfusion / breathing trouble, etc.) is also vulnerable to ROP.

How often should the retina be examined?

ROP can progress within 7 to 14 days and, therefore, needs a close follow-up (as advised by your doctor) till the retina matures.

What is the treatment for ROP?

ROP is treated with laser rays or a freezing treatment (cryopexy). The inner lining of the eye (retina) at the ends of these vessels is treated with lasers to seal the blood vessels and prevent further abnormal growth of the blood vessels. If left untreated the retina may get detached with further vision loss.

When should we treat ROP?

Stage 1 and Stage 2 does not usually need any treatment. These stages may resolve on their own without further progression. ROP needs to be treated as soon as it reaches a critical stage called threshold ROP. If the retina detaches then it becomes either Stage 4 or Stage 5 and in these cases surgery is needed. Surgery for these stages has very poor visual outcome. There is a 50% or greater risk of vision loss if left untreated after this. Hence, consistent follow-up check ups are necessary. Time is crucial!

After Treatment

If treated on time, the child is expected to have reasonably good vision. All premature babies need regular eye examinations till they start going to school.

Are there long-term effects of ROP?

Premature infants more frequently need glasses in early childhood than children who were not premature. This may be the case even if your child did not have ROP, but it is more common in those with ROP. It is also possible to develop “lazy” eye (amblyopia) or “wandering” eye (strabismus) and hence may require treatment for the same. Sometimes, they may need treatment for cataract, glaucoma, retinal detachment.

It is of utmost importance to come for follow up as specified by the eye doctor (Retina specialist). These examinations could save your child’s sight. Please don’t miss them!

© 2012 K K EYE Institute - Pune India.