RETINOPATHY OF PREMATURITY

Retinopathy of Prematurity (ROP) occurs in premature babies when abnormal blood vessels and scar tissue grow over the retina. The retina is the light gathering layer of the eye, akin to the film in a camera.

This condition affects premature babies usually weighing less than 3 pounds at birth. The lower the birth weight the more chance ROP will develop. Dr. Kronwith will often be called into the nursery to see your premature baby since ROP usually develops before the baby's discharge from the hospital. They will then call you to discuss your baby's condition. Sometimes, especially with larger babies, the first exam will not be needed before discharge and the nursery staff will arrange for you to call the office to set up an appointment. This appointment is vital, as are all follow up appointments, since ROP is a potentially blinding disease and your baby must be followed closely until he or she is out of danger, this usually being at about 1 month past the due date.

The actual examination will require the instillation of eye drops, 10 minutes apart for three times. One half hour after the third drop, your baby will be examined. This examination looks as if it should be painful, but it is absolutely not. Anesthetic drops will be put in your baby's eye to guarantee this. The exam requires using a thin metal clamp to keep your baby's eyes open. The eyes will also be manipulated with a metal probe. Again, due to the anesthetic, this exam is absolutely painless. Your baby will cry during the exam since a bright light will be shining in his or her eyes but once the light goes out the baby usually goes back to sleep.

The cause of ROP is not completely understood. It was once thought that oxygen given in the nursery was entirely responsible. Now we know that this is not true. How premature your baby is, the birth weight and other medical problems that arise all play a role in the development of ROP.

In about 90% of cases of ROP, the retinopathy will regress without causing the most serious of problems. In about 10%, bleeding and scar tissue formation may lead to distortion or detachment of the retina which may result in moderate to total loss of vision.

Only a very small percentage of babies become blind. Nearsightedness (myopia) is common in children with ROP. Eyeglasses may improve the vision of these children. Strabismus is often more common in babies who have had ROP. Because of the development of myopia and strabismus, your baby should be seen yearly for 3-4 years once the acute stage of ROP is over.

Until ROP regresses, your child is at risk for loss of sight. Because of this it is imperative that you keep any first or follow-up appointment in our office. Failure to keep these appointments may lead to blindness in your baby.

If Dr. Kronwith sees the condition in your baby deteriorating, laser therapy will be recommended. Studies have shown that laser therapy can reduce the incidence of very poor outcomes. It does not,unfortunately, always work. If your baby's condition deteriorates to the point where the doctor feels laser treatment is indicated, he or she will go over all the details and statistics regarding this treatment.

As mentioned, periodic eye examinations will be necessary as your baby grows to ensure that his or her vision is developing as normally as possible