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Retinopathy of Prematurity

more about Retinopathy of Prematurity


ROP



  • Damage to the blood vessels in retinas of premature infants' eyes (infants born before the 37th week of pregnancy)

  • It is not expected that a premature infant would have any symptoms from this.  The physician could find some of the following "signs" of ROP:
    1. New blood vessels forming in the retina, which do not belong there
    2. Scarring of the retina (cicatrix)
    3. Retinal detachment

  • Years ago, it was thought that the cause was solely a higher-than-normal oxygen level in the bloodstream (the result of a high amount of supplemental oxygen needed by sick premature infants in the neonatal period).
  • When the amount of supplemental oxygen was strictly controlled (so that the oxygen level in the bloodstream did not rise higher-than-normal), there were still new cases of premature infants with ROP.
  • It was next found that premature infants who needed many days of oxygen treatment tended to develop ROP, even though the oxygen level in the bloodstream did not rise higher-than-normal, as far as we know.
  • It is not known if it is solely the oxygen treatment that is the cause, or if being a sick premature infant for a prolonged number of days also is a cause.
  • Sick premature infants who did not have higher-than-normal oxygen levels in the bloodstream still have developed ROP.  Oxygen-use may not be the only cause of ROP, but almost all cases of ROP occur in premature infants who had supplemental oxygen-use.

  • In general, diagnosis starts with an ophthalmologist's examination of premature infants who required supplemental oxygen, especially those of very low birth weight.  Low birth weight infants are often included in the group to be examined, even if they did not need supplemental oxygen.
  • In general, the first eye examination is done before the premature infant is 6 weeks old, and preferably before hospital discharge.

  • Prematurity
  • Birth weight under 3 1/2 pounds, although ROP can occur in babies of higher birth weight
  • The more severely low birthweight the premature infant is, the more likely is ROP.
  • Brain hemorrhage in the premature infant
  • Highly intense light in the incubator might be a risk factor
  • Blood transfusion might be a risk factor, because blood from an adult carries oxygen in a slightly different way than does newborn blood.  This might release more oxygen into the retina than the newborn's own blood would do.
  • Unknown risk factors.

  • It is common, now, for premature infants to be examined by an ophthalmologist (a physician specializing in eye disease) during or after a premature infant's hospital stay.  This is done to diagnose and treat ROP at the earliest possible moment. 
  • Treatment once ROP has occurred:

- Cryotherapy (treatment with a source of cold temperature)


  • Severe Myopia (nearsightedness)
  • Imbalance of the muscles that move the 2 eyeballs, so that one eye might drift right, left, up, or down compared to the other eye
  • Scars in or near the retina (cicatrix)
  • Retinal folds or retinal detachment
  • Glaucoma (a painful condition where there is too much pressure in the eyeball)
  • Amblyopia (decreased vision not correctible with glasses or corrective lenses)
  • Decreased vision which could be temporary or permanent
  • Blindness

  • Frequent measurements of the blood oxygen level
  • Avoiding higher-than-normal oxygen levels in the bloodstream, if possible
  • Laser Treatment 

  • Discuss oxygen use with your physician, if a premature infant is born.
  • Have your premature infant examined by an ophthalmologist, at intervals
  • Report any signs of decreased vision to the attending physician at once, generally signaled by a newborn's visual inattentiveness to:
    1. Mother's face
    2. Brightly colored objects
    3. Moving objects
  • If your baby seems to be having eye pain, report it to your physician at once.

  • Scarring of the retina from injury




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