Retinopathy of prematurity, ROP, is an eye disease that affects infants that are born prematurely.  A premature birth is when your child is born any time before 31 weeks.  Retinopathy of prematurity is when abnormal blood vessels grow in the retina. 

The retina is the part of the eye that senses light, and then sends signals to the brain so that you can see.  ROP can lead to serious eye and vision problems.  In severe cases it can even cause blindness.  

Out of all the babies born in the United States.  Fourteen thousand to sixteen thousand babies will have ROP.  Ninety percent of these cases will be mild and not need any treatment.  Eleven hundred to fifteen hundred of these babies though will have a severe form and need treatment.  Only four hundred to six hundred of those babies will ROP cause legal blindness.  

The retinal blood vessels start to grow at 16 weeks while your child is in your womb.  The blood vessels continue to grow until your baby is born.  Being born early disrupts this process of development, or can cause abnormalities.  There are usually no signs of retinopathy of prematurity.  It is important that if your child is born prematurely that an ophthalmologist examines them.  

 

Risk Factors

There are risk factors that can cause your child to be more at risk of retinopathy of prematurity.  The main one is being born prematurely. 

Another risk factor is if the birth weight is 3 pounds or less. 

If the baby suffers from a respiratory distress syndrome, intracranial hemorrhage or an infection it may also put them at a higher risk of ROP.  

 

Stages Of ROP

There are five stages of ROP.  The first and second stages are mild cases that usually end in the babies getting better without needing any treatment. 

  • Stage one and two babies have healthy vision, but still need to be closely monitored throughout their lives. 
  • Stage three there are some babies who will be better with no treatment and have healthy vision.  Where other babies in stage three will need some treatment to stop retinal detachment from occurring. 
  • Stage four is when the retina is partially detached and treatment is needed to save the vision.  Some vision loss may occur. 
  • Stage five is when the retina is completely detached, vision loss is common, and even sometimes blindness.

Stages four and five are very serious, and usually need some form of treatment.  Stages can progress.  They can progress quickly, so it is important that your child stays monitored and has follow up appointments. 

 

Treatment

The goal for treatment of ROP is to stop the progression of the disease as well as to try to prevent blindness.  Sometimes vision loss can happen even with treatment. 

One form of treatment is done with a laser.  The laser is used to burn the outer edges of the retina.  This helps prevent abnormal blood vessels from forming.  This form of treatment is usually 90% effective.  It successfully can stop ROP from progressing and protects the baby’s vision. 

Another treatment is done with injections.  A doctor will give your baby a shot, or injection, in the eye of anti-VEGF which is a medication that stops abnormal blood vessel growth. 

For babies that are in stages 4 and 5 and have partial or complete detached retinas, your baby will need eye surgery to help repair and restore what vision they can. 

One surgical option is a scleral buckle surgery.  A surgeon will place a flexible band around the sclera, or the white part of the eye.  This band will help support the detached retina until the eye grows normally.  Then the doctor will remove the band. 

The other surgical option your doctor may suggest is a vitrectomy.  This is when the surgeon will replace the clear gel in the middle of the eye with a saline solution.  Then the surgeon removes the scar tissue.  This will help the retina from pulling away completely from the eye.  Your doctor may also use a laser procedure on the other edges of the retina during a vitrectomy as well. 

There are risks with each treatment option.  In some cases some vision loss can still occur like loss of peripheral vision can be normal in some of these treatment options.  

 

Complications

There are some complications your child may face in their life if they have ROP.  If ROP is left untreated it can lead to complete retinal detachment, and blindness.  Children who have ROP are at a higher risk for nearsightedness later in life.  As well as having lazy eyes or crossed eyes.  At any point if you notice your child starts having lazy eye or crossed eye symptoms you will want to see their eye doctor. 

 

Prevention

There is no exact way to prevent your child from getting ROP.  The main cause of the disease is premature birth, so trying to keep a healthy pregnancy and allow your baby to reach 38-40 weeks before being born is the best.  In some instances this is not possible.  

 

Takeaway

Many of the cases of retinopathy of prematurity are so minor that they clear up on their own.  Only a small number of cases are severe enough to need surgical treatment.  Treatment can help stop the progression of the disease, and help restore vision.  Many babies with ROP have healthy vision for their whole lives. 

 

READ MORE:  Everyday Eye Health Care


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