Retinopathy of Prematurity

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.