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Retinopathy of Prematurity

Medically reviewed by Last updated on Oct 31, 2022.

What is retinopathy of prematurity?

Retinopathy of prematurity (ROP) is when abnormal blood vessels develop in your baby's retinas. The retina is the part of the eye that captures light and sends information to the brain. ROP happens in premature babies or low birth weight babies. ROP most often affects both eyes.

What causes ROP?

Your baby's eyes develop during pregnancy. Normal eye development may stop if your baby is born prematurely. The newborn infant's body reacts by making more blood vessels in the retina, but they are not normal. These blood vessels grow larger and spread beyond where they should be in the eye. They are also 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 its position at the back of the eye.

What increases my baby's risk of ROP?

  • Your baby weighs less than 3.3 pounds (1,500 grams) at birth.
  • Your baby is born at 32 weeks gestation or earlier.
  • Your baby needs a ventilator to help him or her breathe.
  • Your baby has to stay in the hospital for a long time after birth.

How is ROP diagnosed?

Infants with a higher risk of ROP are screened for signs of the disease. Your baby's eyes will be numbed to prevent pain. Your baby may be given a pacifier or sweet liquid to soothe him or her. Your baby's healthcare provider will dilate your baby's pupils and look at the back of his or her eyes with an ophthalmoscope. An ophthalmoscope is a magnifying instrument with a light. The provider will look for abnormal blood vessels in your baby's eyes.

How is ROP treated?

Infants with mild ROP may not need treatment. Healthcare providers will ask you to bring your baby to regular eye checkups. This will help healthcare providers monitor your baby's ROP over time. ROP becomes severe when the blood vessels have grown large and twisted. Your baby may need any of the following surgeries if his or her retinopathy is severe:

  • Laser therapy: Your baby's healthcare provider uses a laser to remove abnormal blood vessels.
  • Cryotherapy: Your baby's healthcare provider freezes areas of abnormal blood vessels to slow or stop their growth.
  • Scleral buckling: A band is placed on the eye to help 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: Your baby's healthcare provider removes the cloudy or bloody vitreous gel that fills the center of your baby's eye. The gel is replaced by saline (salt water) to maintain normal pressure in the eye.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

What are the risks of ROP?

Laser therapy and cryotherapy can decrease peripheral vision. Your baby may get an infection after surgery. ROP may get worse, even after treatment. Your child may have vision problems as he or she grows. Your child's vision may be blurry, or he or she may see floaters. Floaters look like spots, cobwebs, strings, or specks. He or she may see flashes of light. Your baby may have blurred vision or blindness. ROP can cause retinal detachment. This is when your baby's retina separates from the back of his or her eye. A detached retina can lead to vision loss.

What can I do to help my baby?

Keep all follow-up appointments. Your baby's healthcare provider will screen for and monitor your baby's ROP. Your baby may need more tests to find other eye conditions that can happen with ROP. Your baby's healthcare provider will go over any test results with you.

Where can I find support and more information?

  • American Academy of Pediatrics
    345 Park Boulevard
    Itasca , IL 60143
    Phone: 1- 800 - 433-9016
    Web Address:

When should I contact my baby's healthcare provider?

  • Your baby has a fever.
  • Your baby's eye is red, swollen, and draining pus.
  • Your baby is not eating or drinking well.
  • You have questions or concerns about your baby's condition or care.

When should I seek immediate care?

  • Your baby is irritable and crying more than usual.
  • Your baby has blood spots in his or her 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 healthcare providers to decide what care you want for your baby. 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.

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