Retinopathy Of Prematurity
What is retinopathy of prematurity?
Retinopathy Of Prematurity Care Guide
Retinopathy (ret-i-NOP-ah-thee) of prematurity is also called ROP. ROP is an eye disease that affects the retina of some premature (born earlier than planned) babies. ROP may also happen among low birth weight babies. ROP ranges in severity from mild (stage 1) to retinal detachment (stage 5). ROP most often affects both eyes.
What causes ROP?
The retina is the part of the eye that captures light and sends information to the brain. During pregnancy, a baby's body, including his eyes, are developing. If your baby is born prematurely, normal eye development can be stopped. The newborn infant's body reacts by making more blood vessels in the retina, but these vessels are not normal. They grow larger, and spread beyond where they should be in the eye. The vessels are weak and may leak blood, causing scar tissue to form on the retina. Over time the scar tissue can make the retina detach (pull away) from it's position at the back of the eye.
 |
What increases my baby's risk of having ROP?
Babies weighing less than 1500 grams (3.3 pounds), or born at 32 weeks gestation (pregnancy lasting 32 weeks) or fewer, are at greater risk of having ROP. Infants whose birth weight was between 1500 and 2000 grams (3.3 and 4.4 pounds) who have certain risk factors are more likely to have ROP. Infants born after 32 weeks gestation with certain risk factors also are more likely to have ROP. These risk factors include needing a ventilator to help with breathing, or staying the hospital for a long time after being born.
What are the risks of having ROP?
With ROP, a child may have vision problems as he grows. His vision may be blurry, or he may see floaters. Floaters can look like spots, cobwebs, strings, or specks. He may see flashes of light. Retinopathy of prematurity can cause retinal detachment. Retinal detachment is separation of the retinal tissue from inside the wall of the eye. A detached retina may lead to partial or complete blindness.
How is ROP diagnosed?
Infants who are at higher risk of having ROP are screened (checked) for signs of the disease. To screen infants, a special eye doctor called an ophthalmologist will use medicine to numb your baby's eyes so that he is comfortable. Your baby may also be given a pacifier or a sweet liquid (oral sucrose) to soothe him. The caregiver will dilate (open) your baby's pupils and look into your baby's eyes using a test called binocular indirect ophthalmoscopy. The caregiver looks for growing or spreading abnormal blood vessels in your baby's eyes.
How is ROP treated?
Caregivers will ask you to bring your baby for regular eye check-ups. It is very important that caregivers see your baby to learn if his retinopathy of prematurity is changing over time. Infants who have mild ROP may not need treatment. Surgery to treat ROP is not done often, but may be needed if the retinopathy is severe. ROP becomes severe when the blood vessels have grown large and twisted. Ask caregivers for more information if your baby needs surgery:
- Laser therapy: A laser is used to remove the outer edge of the retina, where abnormal blood vessels have grown. Laser therapy can slow down or stop abnormal blood vessels from growing.
- Cryotherapy: A tool is used which produces cold temperatures. The tool destroys areas of abnormal blood vessels on the outer edge of the retina. Cryotherapy can slow down or stop the growth of abnormal blood vessels.
- Sclera buckling: Sclera buckling may be done for severe ROP. A band placed on the eye helps prevent fluid inside the eye from pulling on scar tissue. This helps prevent retinal detachment. The band is removed at a later date as your child grows.
- Vitrectomy: Vitrectomy may be done for very severe ROP. The vitreous fluid inside the eye is removed. Scar tissue is removed, allowing the retina to stay against the eye, and helping prevent retinal detachment. Saline solution is used to replace the fluid in the eye.
What are the risks of treatment for ROP?
Laser therapy and cryotherapy can decrease the ability to see to the side, but allow forward vision. Sclera buckling and vitrectomy surgery also carry risks. Treatment may not work for your baby. ROP may keep getting worse, even after treatment. Even with treatment, your baby may have vision problems or blindness. The retina may partly or completely detach. Surgery may be needed to reattach the retina. Talk to your child's caregiver about the risks of treatment for retinopathy of prematurity.
What can I do to help my baby?
- Keep all follow-up appointments. When and how often to take your baby to see his caregiver depends on the results of your baby's eye tests, and other factors. Your baby's caregiver will tell you when you must bring your baby for follow-up appointments. In addition to screening for ROP, follow-up tests are used to find other eye conditions that can happen with ROP. Ask caregivers to explain the results of your baby's tests to you in a way that you can understand. Your baby may no longer need retinal screening if treatment has helped improve blood flow to his retina. If your newborn baby has no signs of ROP after a certain amount of time, he may no longer need ROP screening. ROP screening also may not be needed any longer if tests show that the ROP has gone away.
Where can I find support and more information?
Having a baby with ROP may be life-changing for you and your family. Accepting that your baby has ROP is hard. You and those close to you may feel sad or worried. These feelings are normal. Ask your baby's caregiver questions about ROP, and learn more about how you can help your baby. You may also contact the following:
- American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village , IL 60007-1098
Phone: 1- 847 - 434-4000
Web Address: http://www.aap.org
When should I call a caregiver?
Call a caregiver if:
- Your child has a fever.
- Your child's eyesight seems to be getting worse.
- Swelling and redness of your child's eyes does not go away.
- Your child is not eating or drinking well.
- You have questions about ROP, your child's medicines, or his care.
When should I seek immediate help?
Seek help immediately or call 911 if:
- Your older child tells you that he suddenly has very bad eye pain, or he cannot see anything.
- Your child is very cranky and crying more than usual.
- Your child has blood spots or blood in his eyes.
Care Agreement
You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.
Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
