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The inside of the eye, the retina is not fully developed in premature babies. Abnormal blood vessels can develop in such a retina. These abnormal blood vessels can cause internal bleeding and even retinal detachment. This is called Retinopathy of Prematurity (ROP). This condition results in low vision or blindness – both of which are irreversible.
A Retina specialist / trained ophthalmologist can detect ROP after dilating the pupils of the eye using eye drops. An indirect ophthalmoscope or a Retcam can be used to screen for ROP and gauge the severity and the retinal maturity
Babies with a birth weight of less than 1700 grams or those born in under 35 weeks of pregnancy are most likely to have ROP. Pre-term babies who have had problems after birth such as lack of Oxygen, infections, blood transfusions breathing trouble, etc., are also vulnerable.
Follow the “30 DAY ” strategy. The retinal examination should be completed before the 30th day of the life of a premature baby. It should preferably be done earlier (at 2-3 weeks of birth) in very low weight babies (<1200 grams birth weight).
ROP is treated with Laser therapy or by Cryotherapy and rarely may need surgical intervention in advanced cases. The Laser treatment helps stop further growth of abnormal vessels thus preventing vision loss.
ROP can progress in 7-14 days and therefore, needs a close follow-up till the retina matures.
ROP needs to be treated as soon as it reaches a critical stage called Threshold ROP. There is 50% or greater risk of vision loss if left untreated after this.
If treated in time, the child is expected to have reasonably good vision. All premature babies need regular eye examinations till they start going to school. They may need glasses or treatment for lazy eyes/ cross-eyes and sometimes, for cataract, glaucoma and retinal detachment.