What Is Retinopathy of Prematurity?

ROP is caused by abnormal blood vessel growth in an infant's eye. Blood vessels develop from the central part of the retina and it is positioned outwards during development. This procedure is completed a few weeks before the scheduled delivery date. However, it is insufficient for premature babies. ROP does not occur when blood vessels usually grow. On the other hand, the baby develops ROP if the vessels grow and branch abnormally.

Signs/Symptoms

Most ROP symptoms show deep inside the eye area, making them difficult to recognize merely by glancing at your kid. Only an ophthalmologist (a specialist in eye care) qualified to detect and treat ROP can notice these symptoms by inspecting a child's retina using some specialized equipment.

An infant with severe ROP may exhibit obvious symptoms such as nystagmus (abnormal eye movements) and leukocoria (white pupils). If your kid exhibits any of these symptoms, you should take them to an ophthalmologist straight away because they are also common signs of visual impairment.

What Causes ROP?

The retinal blood vessels of a newborn begin to form in the womb from 16 weeks of pregnancy and continue to develop until the child is born. As a result, an early birth may interfere with or result in inappropriate development. Newborns that come before 31 weeks of gestation or weigh less than 1500 grams are the most susceptible.

When ROP first appears in a newborn, there are no warning signs or symptoms. An ophthalmologist's eye exam is the only way to diagnose it.

How Is ROP Treated?

ROP can develop in both mild, self-healing cases and more serious ones. In certain cases, surgery is required to prevent vision loss or blindness.

ROP surgery prevents the formation of aberrant blood vessels. To protect the central retina, treatment focuses on the peripheral retina. Following ROP surgery, the peripheral retina is scared to inhibit abnormal growth and pressure on the retina. Because the technique focuses on the retina's outermost layer, some peripheral vision loss is likely. However, by retaining the central retina, the eye can continue to allow a child to do critical functions such as looking straight ahead, discerning between colours, reading, and so on.

Surgery

The following are the most common ROP surgical techniques:

Laser surgery, often known as photocoagulation, is the most commonly known as ROP treatment. In this process, tiny laser pulses scar the margins of the retina.
A medication injection is given to the eye. This can be used instead of or in addition to laser surgery. This more modern treatment has shown good results and typically allows blood vessels to grow more consistently. The medication's long-term harmful consequences on preterm neonates are currently being investigated by researchers.

These methods are used in advanced cases of ROP with retinal detachment:

Scleral buckling is a condition in which a flexible band, usually formed of silicone, encircles the whole eye. As a result of the band wrapping around the white of the eye, the detached retina is pushed closer to the eye's outer wall.
The transparent gel in the centre of the eye is replaced with a saline solution (salt) during vitrectomy (the vitreous). This reduces tension on the retina, preventing it from pulling out, and allows the surgeon to remove scar tissue.

How Does ROP Surgery Work?

Your baby's ophthalmologist will advise you on the best ROP surgery technique for him/ her. ROP surgery is commonly conducted on children who are sedated or under general anaesthetic (medication that causes a highly calm state) (the child is awake but not as deeply sedated as with general anaesthesia). While certain operations, such as laser surgery, may be done at a child's hospital bedside, others require an operating room.

Doctors will use drops on the child's eyes to dilate the pupil before the surgery (s). The eyelid speculum is softly put under the eyelids during the process to prevent them from shutting. The heart rate and breathing rate of the newborn are regularly monitored.

The eye will be patched following scleral buckling and vitrectomy, but not after laser surgery or injection. The length of the hospital stay is decided by the medical state of the child and his or her age at the time of the operation.

It is always best to consult a medical professional to treat ROP properly and as effectively as possible.

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

1. How often is ROP?

Every year, around 1,100 to 1,500 children suffer from severe ROP, necessitating medications to avoid vision loss, and 400-600 infants become legally blind. The smaller a baby is at birth, the more probable he or she may get ROP.

2: How successful is ROP therapy?

Some neonates, however, may not respond to ROP treatment, and retinal scarring or detachment might still occur—usually on a tiny region of the retina. ROP treatment can lower the chance of blindness. A partial retinal detachment may resolve on its own, therefore treatment is usually unnecessary. In rare cases, therapy may be recommended to prevent a total retinal detachment, which would need surgery to reconnect the retina.

3. Can ROP cause other complications?

Yes. ROP infants are more prone to suffer retinal detachment, nearsightedness, strabismus (crossed eyes), amblyopia (lazy eye), and glaucoma later in adulthood, among other visual problems. Fortunately, many of these eyesight problems are treatable.

4. Is there anything else I should be aware of?

ROP surgery is intended to delay the course of the disease and avoid blindness. Although ROP surgery has a high success rate, you should be aware that not all neonates respond to treatment. This medication may not function in a few unusual circumstances.

5. What should my reaction be to this treatment?

If a child does not need to stay in the hospital, you can take them home an hour following surgery. Eye drops will be required for at least a week to avoid infection and/or discomfort. Attend all of the following eye checkups to ensure that your baby's eyes recover correctly and that ROP does not reoccur.