Retinopathy
of prematurity (ROP) is an eye problem that happens to some very
premature babies. Most very premature babies do not develop any ROP and
in babies who do develop ROP it is usually mild and goes away by itself,
without causing any problems with vision. |
What is ROP? |
ROP
is a problem with the way the blood vessels develop on the surface of
the retina in the weeks after birth. (The retina is the layer at the
back of the eye that is like a film in a camera – see figure 1.) When a
baby is born very prematurely, these blood vessels are immature like the
rest of the baby. In most very premature babies, the retinal blood
vessels grow properly, however in some, the blood vessels start to grow
the wrong way. Instead of branching like a tree, the vessels link up
side to side and in some cases grow away from the retina towards the
centre of the eye. The severity of ROP is graded from stage one to stage
five. Stage one is the mildest and stage five the most severe. |
Figure 1: Major parts of the eye |
Why do premature babies get ROP? |
We
do not understand why some babies develop ROP and others do not. Much
research continues to be done to solve this mystery. Serious ROP is very
rarely seen in babies weighing more than 1,250 grams at birth. Many
years ago ROP was more common and was linked to excessive use of oxygen.
Now the supply of oxygen to premature babies is very closely monitored
and the amount of oxygen given to your baby is very carefully calculated
and controlled. As a result, ROP is less common but it still occurs. It
is well known that the sicker and smaller a baby is the more likely it
is that ROP will develop. |
How will I know if my baby is getting ROP? |
We
cannot predict which babies will develop ROP. All babies weighing less
than 1250 grams at birth will have regular eye examinations after their
gestational age reaches 30 to 31 weeks. These examinations are done by a
medical eye specialist (ophthalmologist). The specialist will use eye
drops to dilate the pupil (black circle in the middle of the coloured
part at the front of the eye – see figure 2) which helps them to look at
the back of a baby’s eyes. The examination only takes a couple of
minutes. Your baby may be minimally upset by these examinations and will
settle very quickly once the eyes have been checked. After each
examination a result sheet will be left to tell you if any ROP was found
and if it was found how severe it was. This sheet will also indicate if
the ROP is getting better or worse. |
Figure 2: Eye drops make the pupil larger so the retina can be examined |
If my baby has ROP, what happens? |
In
most babies, ROP is mild and over a period of weeks the ROP gradually
disappears. The ophthalmologist will check your baby’s eyes every one or
two weeks and you will be told the result of each examination. |
Can ROP be treated? |
Yes,
but remember very few babies develop ROP that is bad enough to need
treatment. At the Royal Women’s and Royal Children’s Hospitals only
about 2% of babies checked for ROP actually need treatment. Mild ROP
does not need treatment as it almost always goes away by itself. If your
baby needs treatment, treatment options will be discussed with you. The
treatment is generally done with laser and in 90% of babies needing
treatment, the ROP disappears and sight is preserved. If your baby needs treatment, more information will be given to you and you can discuss the situation with the paediatricians and ophthalmologist caring for your baby. |
Who can I talk to about ROP? |
The
nurse or doctor taking care of your baby are always the first people to
ask. If they cannot answer your questions they will arrange a time for
you to discuss your baby’s eye problems with the ophthalmologist. |
Will my baby need to have eye checks after leaving hospital? |
All
babies who are small enough to have their eyes checked while in
hospital will be offered an eye examination at one year of age. A small
number of these children are found to have turned eyes or need glasses
for clearer vision, even if they did not have any ROP while in hospital.
It is strongly recommended that you make sure your baby has an eye
examination at about one year of age. |
Remember |
Only some babies with birth weights less than 1250 grams develop ROP and in most of these babies the ROP is mild and goes away without treatment. Only a very few babies develop severe ROP and treatment is successful in most cases. |
Thursday, October 17, 2013
Retinopathy of prematurity (ROP)
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