Retinopathy of Prematurity (ROP)
A disease that occurs in some premature babies, Retinopathy of Prematurity, is the growth of abnormal blood vessels in the retina that generally begins during the first few days of life and may progress rapidly to blindness over a period of weeks. This process occurs because the eye is rapidly developing during gestational weeks 28-40. The blood supply to the retina starts at the optic nerve at about 16 weeks gestation and blood vessels grow out from there toward the edges of the retina until the time of birth. When a baby is born prematurely, this normal vessel growth stops and as a result new abnormal vessels begin to grow. Over time this vessel growth produces a fibrous scar tissue which attaches to the retina and the vitreous gel. This ring may extend 360 degrees around the inside of the eye. If enough scar tissue forms, it can begin to pull the retina, detaching it, and, in some cases, causing blindness.
Select one of the two players, to the left, to view a short video illustration of retinopathy of prematurity in an infants eye.
 | Low birth weight (3.5 pounds or less) |
| The need for any oxygen within the first week after birth |
| Unstable health immediately after birth |
Children with ROP as infants should be watched for the following symptoms as they age
| Holding objects very close |
| Difficulty seeing distant objects |
| Favoring or winking one eye |
| Reluctance to use one eye |
| Poor vision (previously undetected by the physician) |
| Sudden decrease of vision |
| Crossed or turned eye |
Detection and Diagnosis
Premature infants at risk for ROP should have an ophthalmic examination at approximately 4-6 weeks of birth. After instilling a series of dilating drops in each eye, the doctor examines the retina with an ophthalmoscope. ROP is diagnosed by stages of developmental growth.
Treatment
Infants with stage I or stage II ROP usually will not require treatment as these stages often resolve over a period of weeks. If ROP progresses to stage III, or if abnormal blood vessels form, laser surgery may be needed. The laser treatment causes the existing abnormal vessels to die and discourages the formation of new ones preserving the baby's vision. It stops the progression of the ROP when it does not resolve on its own.
Regardless of whether treatment is required, children should be re-examined at recommended intervals to determine if the progression of the disease has halted, or whether treatment is required.