Retinopathy Of Prematurity

What is retinopathy of prematurity (ROP)?

The retina is a delicate tissue lining the back of the inside of the eye whivh detects light and allows us to see. ROP is an eye condition which affects the blood vessels of the retina. The white oval in the centre is the optic nerve and dark area towards the right is the macula, which allows to see fine details

ROP develops, usually progressing over time from normal to stage 1,through stage 2 to stage 3. Mild ROP of stages 1 and 2 are very common and ay settle on there own. Only a small portion of babies develop plus disease and stage 3 which is more serious.

What is screening for ROP?

ROP screening is eye examination by a retina specialist to look for any signs of ROP. All prematurely born babies need at least one eye screening examination.

How common is ROP?

ROP is common in premature babies .The condition may be mild many times and settle on its own but monitoring the eye is important. In very few bbies (usually smallest and most premature) the ROP can seriously affect a baby’s sight and even cause blindness.

Why does ROP occur?

NO one knows exactly why , When a baby is born early, the blood vessels of retina are not fully developed. After birth something triggers the blood vessels to start grow abnormally and this forms scar tissue , which, if severe can damage the retina. The main cause of ROP is prematurity itself, so the more prematurely the birth occurs the greater the risk of ROP occurring. However, some premature babies who have no serious illness still develop ROP, while others who have been very ill do not. Therefore, it is necessary to screen all the premature babies.

When will the screening be done?

The first screening examination will be done when your baby is between 4 and 6 weeks old . Some babies will need only one examination although most babies need at least two.

What happens during screening?

About an hour before the examination, eye drops are put in the eye to make the pupil open widely so as to see the retina. The retina specialist examines the retina of baby using a head band ophthalmoscope. They may also use a speculum to keep the eye open and an indenter to enable better view of retina.

Is the examination painful?

Anaesthetic eye drops are used to minimize the discomfort to your baby. Even then babies sometimes cry when their eye are examined.

What happens if ROP is found?

This depends on how serious it is

if ROP is mild , a follow up examination should be done 1-2 weeks later
More severe ROP will require an ealier re-examination, usually within a week.
In a very few cases ROP may be severe enough to require treatment.
Treatment depends on stage of ROP. For early stages only retinal laser is required and in late stages retinal surgery may be warranted. If your baby requires treatment the doctor will talk to you to explain exactly what will happen