What is Retinopathy of Prematurity (ROP)

Retinopathy of prematurity is an eye disorder that can affect babies who are born too early (prematurely). ROP can lead to vision loss. The amount of vision loss depends on the severity of the condition.

What are the causes?

This condition occurs when blood vessels in the eye grow abnormally. These abnormal blood vessels are very fragile and may bleed easily. They may cause scar tissue to form within the eye.

ROP causes vision loss if the abnormal blood vessels and scar tissue cause the light-sensitive membrane at the back of the eye (retina) to change shape, pull away, or detach from its location in the back of the eye.

What increases the risk?

This condition is more likely to develop in babies:

• Who are born prematurely, usually before 31 weeks.
• Who are small, usually under 2¾ lb (1.25 kg).
• With a low amount of red blood cells (anemia).
• Who have received donated blood (transfusions).
• With breathing problems (respiratory distress).
• Who have a condition that causes breathing to stop briefly (apnea).
• Who have an infection.
• With heart conditions.
• With a slow heart rate (bradycardia).
• Who are receiving high levels of oxygen or have had a big change in oxygen levels during treatment.

What are the signs or symptoms?

This condition may be associated with poor eyesight. Infants are too young to accurately measure vision.

How is this diagnosed?

This condition is diagnosed with an eye exam by an eye specialist (ophthalmologist). During the exam, the ophthalmologist will put drops into your baby’s eyes and examine them with a special lighted instrument (ophthalmoscope). He or she will check for:

• Abnormal blood vessels.
• Bleeding in the eye.
• Formation of scar tissue.
• Detached retina.

Occasionally, special photographs of the back of eye may be taken and sent to a doctor to review (telemedicine).

How is this treated?

Treatment for this condition depends on the severity of the ROP. If the condition is mild, it may not require treatment and it may go away on its own. If the condition is more severe, treatment may include:

• Laser phototherapy. A laser beam is directed through the pupil to keep ROP from getting worse. This is the most common treatment.
• Cryotherapy. In this treatment, a small pen-like instrument is used to briefly freeze the sides of the retina.
• Surgery, such as:
  • Scleral buckle. This procedure places a plastic band around the eye to help flatten the retina and keep it in place.
  • Vitrectomy. This procedure removes the gel-like substance that fills the eyeball. After the substance is removed, the eyeball is filled with a salt (saline) solution. This helps stop the retina from pulling away from the back of the eye.
• Injections of bevacizumab. This medicine helps to stop abnormal growth of blood vessels in the eye.

Follow these instructions at home:

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• If the health care provider prescribes eye drops to be given to your baby before an exam, be sure to give the eye drops exactly as directed.
• Wash your hands with soap and water before you give eye drops to your baby. If soap and water are not available, use hand sanitizer.
• Keep all follow-up visits as told by your child’s health care provider. This is very important.
  • Your baby will need regular eye exams throughout childhood as he or she may be at higher risk for other eye problems, such as crossed eyes, lazy eye, and cataract.

Contact a health care provider if your child:

• Develops redness or swelling of the eye.

Get help right away if your child:

• Develops severe redness or swelling of the eye.

Summary

• Retinopathy of prematurity (ROP) is an eye disorder that can affect babies who are born too early (prematurely).
• ROP is a serious condition. It can cause vision loss. However, with early screening tests and treatment, most children retain their vision.
• The most common treatment for this condition is using laser beams to stop ROP from getting worse. Other treatments include freezing portions of the retina or doing surgery to correct the problem.
• Follow instructions from your child’s health care provider for giving medicines and eye drops.
• It is important to keep follow-up visits as told by your child’s health care provider. This may prevent other eye problems from developing.