WHAT IS RETINOPATHY OF PREMATURITY?
The back part of the eye which is sensitive to light is called the RETINA. It receives visual signals , processes them and sends them to the brain which in turn results in meaningful vision. This sensitive layer called Retina receives its nutrition in the form of Oxygen from Blood Vessels.
The eye develops rapidly in the last 12 weeks of Fetal life. A baby born prematurely will have some degree of immaturity in the Retina and therefore is it risk of developing Retinopathy of Prematurity (ROP). Babies who have ROP have blood vessels which do not grow normally. This abnormality is detected by routine screening tests.
Various studies show that incidence of ROP in preterm neonates is seen in about 20% and treatment is required in only 20% of those diagnosed with ROP.
HOW IS ROP DIAGNOSED?
Premature babies <36 weeks and/or Low Birth Weight babies <2000gm are routinely screened for ROP. The first examination must be carried out within 30 days of birth. For high risk babies the first examination should be done within 20 days of birth.
Most premature babies have the eye examination before they leave the hospital. If discharged
DOES ROP CAUSE PERMANENT DAMAGE TO THE EYE?
Most cases of ROP do not cause any vision loss. If ROP is detected in early stages and treated if required at appropriate stages, there is no vision loss. However if left untreated it can also progress to severe stages of disease and can also lead to irreversible blindness.
Thus it is very important to keep your appointment with the eye doctor. This may prevent blindness.
HOW SERIOUS IS MY BABY’S ROP?
ROP is broadly divided into 5 stages. Stage 1 being mild and stage 5 most severe. Most of the babies diagnosed with ROP have a stage 1 or 2.
Stage 1 – Mild abnormality of blood vessels with formation of Demarcation Line.
Stage 2 – Increased vessel abnormality with formation of RIDGE.
Stage 3 – Proliferation of these blood vessels into Vitreous Cavity.
Stage 4 – When these severe abnormal blood vessels cause part of Retina to detach from its underlying surface.
Stage 5 – The whole of Retina is now detached due to pull from abnormal blood vessels
WHAT TREATMENT IS NEEDED FOR THE BABY?
In early stages of ROP such as stage 1 or 2, no treatment is needed. The abnormal blood vessels regress on their own. No vision loss occurs in the long run.
However, for severe cases of ROP, treatment might be required, which includes
WHAT TO EXPECT DURING ROP SCREENING?
ROP screening is ideally done by a Retina specialist who is trained in dealing with ROP cases. To screen the baby’s eyes are Dilated using special low strength dilating eye drops.
It takes about 30-35 minutes for adequate dilation
Prior to examination anesthetic eye drops are instilled in both eyes. To open the eye lids a soft delicate metallic eye speculum is placed and an indenter is used to rotate the eye ball. The child cries during the examination but all precautions are taken to make it smooth and painless for the baby.
Eye screening usually takes less than 1 minute for both eyes.