When is an ROP screening required?

Retinopathy of Prematurity is classified as an eye condition that affects premature babies who, at birth, weigh less than 3 pounds. The retina, a layer of light-sensitive tissue towards the back of the eye, is covered with nerve cells that react to light. Beneath the retina is a group of blood vessels that usually grow rapidly before birth. In premature babies, however, the vessels may not grow properly, resulting in ROP. While some infants with ROP may recover without treatment, others require intervention to prevent blindness or protect their eyesight.

What are the types of ROP?

Retinopathy of prematurity is characterised by stages, which range from mild stage 1 to severe stage 5. Doctors use these stages to track the severity of the condition. Generally, those in stages 1 and 2 typically improve without treatment but require close monitoring to ensure that the ROP does not worsen.

Those in stage 3 may require treatment to prevent the development of further complications, such as retinal detachment, which could lead to vision loss. For those in stages 4 and 5, surgery is often the recommended course of action, though even with treatment, vision loss is still a possibility.

Are there symptoms of ROP?

A baby who has had ROP in the past may have certain signs and symptoms, including eye wandering, shaking, difficulty recognising faces, and white pupils. With time, they may also experience more serious eye problems, such as retinal detachment, amblyopia (lazy eye), nearsightedness, and crossed eyes. To ensure that the eye problems resulting from ROP are treated properly, it is important to keep up with regular checkups and eye exams.

What are the causes of ROP?

During pregnancy, the blood vessels that form the retina typically begin to develop in the fourth month and typically complete their formation by nine months. However, if a baby is born prematurely, these blood vessels may not be able to finish developing properly. This is referred to as retinal neovascularization.

In some cases, these abnormal blood vessels may start to grow in the wrong direction, attaching themselves to the retina. If this occurs, the vessels can pull the retina away from the eye, causing a retinal detachment.

How is ROP screening performed?

A doctor will administer the Retinopathy of Prematurity (ROP) screening. To facilitate the examination, dilating drops will be used to enlarge the pupil. As babies are usually unable to keep their eyes open for an extended period, a speculum—a rounded instrument—is used to keep them open for the duration of the exam. Additionally, a depressor may be used to direct the eye and provide the doctor with a better view.

It is important to note that both the speculum and the depressor are placed on the exterior of the eye and neither cause any pain nor puncture the eye; they are removed soon after the exam is completed.

During the ROP screening, the bright light required for the lens to be seen through may be uncomfortable for the baby, causing them to cry. While the light itself is harmless, it is recommended that you offer your baby comfort during and after the exam. It is important to note that the pupil of the eye may remain dilated for 3–8 hours post-screening, and they may have an increased tendency to close their eyes during this time.

How is ROP treated?

Laser photocoagulation is one of the most common treatments for ROP. During this procedure, a surgeon directs a laser beam onto the affected area of the retina, creating a localised burn that stops the abnormal growth of new blood vessels. This heat-based damage helps to shrink the vessels and prevent further progression of the condition. In some cases, the abnormal vessels may even disappear altogether.

Cryoretinopexy is a medical procedure that uses a cryoprobe—a tool with a very cold tip—to freeze and shrink abnormal blood vessels in the eye. This is done to stop their growth and limit further damage. The process is minimally invasive, with the cryoprobe being placed on the outside of the eye and no incisions necessary. Cryoretinopexy is a safe and effective treatment option for patients with abnormal blood vessel growth.

Scleral buckling is a procedure used to reduce the tension on a damaged retina caused by abnormal blood vessels and scar tissue. This technique involves placing an elastic band around the circumference of the eyeball to push the inside surface against the retina, helping to reattach it to the inside surface. The elastic band is typically removed once the eye has outgrown it or when the retina has been reattached.

For the small number of infants who require treatment for ROP, the treatments are usually successful in avoiding vision loss. To ensure the best possible outcome for their child, parents should be sure to attend all of their scheduled appointments and carefully adhere to the doctor's instructions after the treatment.

Request an appointment at Apollo Cradle, Bengaluru - Jayanagar. Call 1860-500-1066 to book an appointment.

1. Is it common for babies to have ROP?

About 10% of premature babies have ROP.

2. Does ROP go away on its own?

If the ROP is in stages 1 and 2, it has a good chance of regression without medical intervention.

3. Are there any complications associated with ROP?

Retinal detachment, bleeding, retinal scarring, and loss of vision are some of the complications associated with ROP.

4. Is surgery a safe option for treating ROP?

Both vitrectomy and scleral buckle surgery are standard surgical procedures for treating ROP.

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