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  • Writer's pictureAtanas Bogoev M.D. and Maria Cholakova

Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is a potentially severe eye condition that may affect premature babies. It occurs when the blood vessels in the baby's eyes don't develop properly. In this guide, we will provide you with in-depth information about ROP, its causes, symptoms, diagnosis, and treatment. We will also share what you can do to ensure the best care for your premature baby.

What is Retinopathy of Prematurity?

Retinopathy of prematurity (ROP) is an eye problem that primarily affects premature infants. Particularly those born before 31 weeks of gestation or weighing less than 1,250 grams (2.75 pounds) at birth. The exact cause of ROP is not fully understood. However, it may be due to an incomplete development of blood vessels in the retina, which is the light-sensitive tissue at the back of the eye.

In a normal pregnancy, blood vessels in the retina continue to grow and develop until the baby is full-term. However, in premature infants, the blood vessels may not have fully reached the edges of the retina at the time of birth. As a result, the abnormal blood vessels may develop and lead to retinopathy of prematurity.

Stages of ROP

The severity of ROP can vary. In mild cases, the condition may resolve on its own as the infant grows. In more severe cases, abnormal blood vessels can progress and cause scarring. That may result in retinal detachment, which can cause permanent vision loss if not treated promptly.

Retinopathy of prematurity is classified into five stages. With stage 1 being the mildest and stage 5 being the most severe. The stage helps doctors determine the appropriate treatment plan and the risk of vision loss.

Risk Factors for Retinopathy of Prematurity

Several factors can increase the risk of retinopathy of prematurity in babies, including:

  • Premature birth

  • Low birth weight

  • Supplemental oxygen therapy (NICU)

  • Anemia

  • Respiratory distress syndrome

Retinopathy of Prematurity Symptoms

The condition often does not have noticeable symptoms in its early stages. As it progresses, you may observe the following signs in a ROP baby:

  • Abnormal eye movements

  • Crossed or misaligned eyes

  • White or grayish appearance in the pupil

  • Severe nearsightedness

Retinopathy of Prematurity Diagnosis

Pediatric ophthalmologists diagnose babies with ROP through an eye examination. The eye exam typically involves dilating the baby's pupils to get a better view of the retina.

Premature infants need to receive appropriate medical monitoring and care to detect and manage conditions like ROP early on. That increases the chances of preserving vision.

Eye examinations often start a few weeks after birth. Regular follow-up visits to the eye doctor continue until the baby's retinal blood vessels mature or any necessary treatment is completed.

retinopathy of prematurity rop

Treatment Options for Retinopathy of Prematurity

The management of retinopathy of prematurity in babies depends on the severity of the condition.

Treatment options for mild cases of ROP may include:

  • Observation: Many cases of ROP resolve on their own without treatment.

Treatment options for moderate and severe cases of ROP may include:

  • Laser Therapy: A common treatment method where a laser shrinks the abnormal blood vessels.

  • Anti-VEGF Medications: These medications may be injected into the eye to stop the growth of abnormal blood vessels.

  • Cryotherapy: In some cases, extreme cold is used to treat the damaged retinal tissue.

  • Surgery: Prevents the progression of abnormal blood vessel growth.

How to Support Your Baby?

Supporting a premature baby with ROP involves a combination of medical care, monitoring, and a nurturing environment. Here are some ways to support a premature baby with ROP:

  • Regular follow-up eye exams

  • Limit exposure to bright lights

  • Provide a supportive and nurturing environment

  • Keep up with overall health and development milestones

  • Breastfeeding for proper nutrition (If breastfeeding is not possible, work with your pediatric team to provide the best nutrition for your baby)

Each premature baby and case of ROP is unique. Doctor's recommendations may vary based on individual circumstances. Remember, as a new mother, you should rely on medical experts for guidance on your baby's health.

Having a premature baby with health concerns can be emotionally challenging for parents. It's crucial to follow the baby's eyes development milestones. Seek support from healthcare professionals, support groups, and family and friends. Taking care of your emotional well-being can, in turn, help you provide better care for your baby.

Retinopathy of prematurity is a challenging condition. But with early diagnosis, appropriate treatment, and ongoing care, many premature babies can go on to live healthy, happy lives with good vision.

Checked by Atanas Bogoev, MD.


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