Retinopathy of Prematurity

Retinopathy of Prematurity (ROP) is a disease that occurs in some premature babies. It 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. Abnormal vessel growth can cause traction on the retina leading to retinal detachments and blindness.

Signs and Symptoms

  • 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:
    • Holding objects very close
    • Difficulty seeing distant objects
    • Favoring or winking one eye
    • Reluctance to use one eye
    • Poor vision (previously undetected)
    • 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 of ROP is considered if it reaches a certain threshold. Depending on the age of the baby and the aggressiveness of the disease either laser or medication can be used. Laser is performed under anaesthesia and targets the areas of the retina where there is no blood supply. If a baby is very premature, or has very aggressive disease an injection of medication can be delivered inside the eye. Sometimes no further treatment is necessary but often laser is necessary after injections.