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What is Retinopathy of Prematurity (ROP)?
When light falls on the retina, which is
the inner lining of the eyeball, it sends information to the brain.
The brain processes it so we can “see.” If you think of the eye being
like a camera, the retina functions as the film. Blood vessels that
supply the retina are one of the last structures of the eye to mature;
they have barely completed growing when a full-term baby is born.
This means that a premature baby’s retina is not yet completely
developed. For reasons not yet fully understood, the blood vessels in
the immature part of the retina may develop abnormally in some
premature infants. This is called Retinopathy of Prematurity or
ROP for short. In a small number of infants, permanent scar
tissue forms inside the eye which pulls the retina out of its normal
position (a retinal detachment). This usually results in severe loss
of vision or blindness. However, in severely affected infants, laser
treatment can be performed which helps to prevent scar tissue
formation and MAY reduce, but not eliminate, the risk of
retinal detachment.
How will we look for ROP in your baby?
The first eye examination on premature
babies (born less than 1500 grams at birth or 32 weeks gestational
age) needs to be performed approximately 4 to 8 weeks after birth.
Follow-up exams are done at one, two, or three week intervals while
the retinal vessels are immature or if early ROP develops. The first
exam is frequently done while the baby is still admitted to the
neonatal intensive care unit and the exams are coordinated by the
ophthalmologist and the neonatologists. However, if the baby is doing
well and can be sent home, these exams can be done in our office as an
outpatient. (See below.)
The exam itself involves administering
drops to dilate the pupils. A small metal spring will be placed in
the eye after a numbing medication drop is placed in order to keep the
eyelids open. This does not hurt the baby in any way. A special
lighted viewing system (the indirect ophthalmoscope) with magnifying
lenses is used by the doctor to examine the entire retina. They eyes
may appear a little pink and swollen after the exam.
What happens after your baby goes home?
Some babies will go home while the retinal
blood vessels are still incompletely developed or developing
abnormally. This means these babies are still at risk for loss of
vision from ROP. An outpatient follow-up exam will be scheduled for
the appropriate time after discharge in our office. THE TIMING OF
THIS APPOINTMENT IS CRITICAL. To delay even a few weeks may
result in a retinal detachment and severe visual loss or blindness.
If you are not able to keep your scheduled appointment, it is very
important that you bring your baby for an eye examination within 1
week. A delay may result in preventable blindness. We strive to
schedule appointments effectively but it will be your
responsibility to contact us as soon as possible if you need to
make a schedule change. If you have questions regarding your baby’s
appointment, please call our office at (305) 662-8390.
After your baby is not longer at risk for
ROP a more thorough eye exam is recommended at 1 year as premature
babies are at greater risk for other eye problems including strabismus
(misalignment of the eyes) and refractive errors. Parents are
responsible for setting up this appointment.
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