Children’s Eye Problems
Retinopathy of Prematurity (ROP)
During pregnancy the normal blood vessels of the retina grow from the center of the retina outward toward the periphery, eventually covering the entire retina with normal blood vessels that give the retina its blood supply. This process is normally complete at about 40 weeks gestation, so that when a baby is born at full term, the retina has its full normal blood supply. However, when a baby is born prematurely, the normal vessels have not had time to get all the way out to the periphery, so that there is a peripheral zone of the retina that does not yet have normal blood supply. It is at the boundary between where the normal vessels have reached and where they have not yet reached that ROP develops. The earliest change of ROP is simply a line of demarcation at the leading edge of the normal blood vessels as they proceed outward. Later this line may become a ridge, and finally abnormal blood vessels can form on the ridge. This is the serious and dangerous form of ROP.
In most cases ROP is mild to moderate and goes away on its own, with no treatment needed. In a small percentage of cases (less than 5%) the ROP becomes severe enough that there is real danger of retinal detachment and blindness, and in these cases laser treatment is needed to stop the progression of the ROP and prevent retinal detachment and blindness.
You cannot see ROP by looking at your child; it is detected by an ophthalmologist looking at the retinas through dilated pupils, beginning in the NICU at 4 to 6 weeks after birth. These exams are initially done every 2 to 3 weeks, and may need to be done more frequently if the ROP worsens. ROP usually reaches its peak severity around the due date or a little before; since babies are often discharged from the NICU around that time, the screenings for ROP often continue every few weeks in the ophthalmologist’s office after discharge from the NICU until it is clear that the risk of retinal detachment is low. It is extremely important that you keep follow-up appointments with the ophthalmologist after your premature infant has been discharged from the NICU. This is not “just an eye exam;” it is an exam that is necessary to make sure your baby does not go blind.
Dr. Young has been examining premature infants for ROP since 1994. He has the experience and the expertise to make sure your premature infant grows up with the best possible vision.