Retinopathy of prematurity (ROP) is a potentially blinding condition affecting babies born prematurely, especially those weighing less than 1,250 grams. With increasing survival among premature births due to advances in neonatal care, there have been an increasing number of these cases.
ROP affects the retina, particularly the immature portion of the retina when the baby is born prematurely. This part of the retina can either develop normally or abnormally. Abnormal development is characterized by stages from the formation of a demarcation line (stage 1) followed by an elevated ridge (stage 2) and, lastly, neovascular growth (stage 3). If untreated, some of these eyes progress to partial retinal detachment (stage 4) and total retinal detachment (stage 5).
Several studies have shown that early treatment reduces the risk of poor vision from structural damage caused by ROP in a subset of infants. Laser treatment can be done for eyes that are at risk. Once the condition reaches stage 4, surgical management (vitrectomy) is an option.
An early referral to the ophthalmologist is essential in screening these babies. The screening should be done: before the baby is discharged from the hospital, if the baby is 4 to 6 weeks old, or if the baby is between 31 to 36 weeks post gestational age. During examination, the baby’s pupils are dilated widely, a topical anesthetic is given and a lid speculum is placed to hold the eyelids open. The ophthalmologist then recommends follow-up or treatment depending on the stage of ROP if present.