Retinopathy of Prematurity

Signs and Symptoms

Subtle changes in a baby's retina are not easily detected and therefore cannot be seen by parents or the pediatric doctors and nurses who are taking care of your baby. Only a pediatric ophthalmologist, a doctor who specializes in eye care, can detect signs of retinopathy of prematurity (ROP) by using special instruments to examine the baby's retina.

Severe and untreated ROP may cause some of the following symptoms:

• White pupils, called leukocoria
• Abnormal eye movements, called nystagmus
• Crossed eyes, called strabismus
• Severe nearsightedness, called myopia

Diagnosis

All premature babies who may be at risk for retinopathy of prematurity (ROP) are carefully monitored and examined for the condition beginning a few weeks after birth, before they are discharged from the hospital. The only way to determine if a baby has ROP is to examine the inside of their eye, to detect if there are any abnormalities in the retina. Ophthalmologists trained in the diagnosis and treatment of ROP will exam your baby's eyes. During this examination, your baby's pupils will be dilated with eye drops so that the retina can be studied. If any signs of ROP are detected, follow-up evaluations will be recommended over the following weeks.

ROP is defined by different stages, based on the severity of the disease. In mild cases, the baby's retinal blood vessels may continue to grow normally, and treatment is not required. In more severe cases, there are marked abnormalities in the development of the retinal blood vessels that, in the most severe cases, can lead to detachment of the retina and blindness. This occurs rarely and only in the most severely affected infants.

Treatment

Treatment for retinopathy of prematurity (ROP) depends on the stage and severity of the condition. The milder stages of the disease typically resolve themselves on their own, and do not require treatment. However, if the disease has progressed to a point where your baby's vision is at risk, treatment is required. Our pediatric ophthalmologist will discuss your child's treatment options in detail with you. The goal of treatment is to reduce the risk of your baby's retina detaching, which can severely impact their vision.

Laser photocoagulation is the most common treatment, in which a laser is directed to a specific spot to destroy abnormal blood vessels and seal leaks. Laser photocoagulation involves little postoperative pain and swelling. Recent research indicates that early treatment of severe forms of ROP is effective in decreasing the amount of permanent eye damage.