If your baby is born prematurely, you may have many questions and concerns about possible health issues. One health issue that affects premature infants is called retinopathy of prematurity (ROP).
This eye condition is serious. It can lead to blindness. But regular eye exams and quick treatment reduce those risks.
ROP Exams at UVA Health Children’s
If your baby is a patient in our neonatal intensive care unit (NICU), they’ll be checked regularly for ROP by one of our children’s eye doctors (pediatric ophthalmologists).
Before their exam, your baby’s eyes are dilated with eye drops. This lets the doctor look at the back of your baby’s eye (called the retina).
During the exam, the eye doctor may use a tool (called a speculum) to hold your baby’s eye open. This isn’t painful, although babies often cry through it. The doctor is looking for abnormal blood vessels in the retina. If ignored, these blood vessels can cause the retina to separate from the eye (retinal detachment) and blindness.
Eye exams are often able to catch these abnormal blood vessel growths before they cause lasting harm.
Retinopathy of Prematurity Treatment Options
If your baby has the early stages of ROP, your doctor may advise waiting to see if it gets worse. Often, ROP heals on its own. Only about 10% of babies with ROP need treatment. But until it starts to heal, frequent exams allow us to catch any changes quickly.
If your baby’s eye exam reveals ROP that’s more severe, it will need treatment. There are 2 main treatment options.
Injections
A medication that slows blood vessel growth is often the best treatment for ROP. This injection can be done at your child’s hospital bed. This therapy is very effective and isn’t painful.
Because it’s so safe and works so well, most doctors prefer this choice. But if your child’s ROP is more advanced or doesn’t respond to injections, surgery is another option.
Laser Surgery
Laser surgery can help very advanced cases of ROP. By placing tiny laser marks along the side of the eye’s retina, we’re able to prevent the retina from pulling away. Though your baby’s eyes may be red and puffy for a couple of days, they won’t have much pain.
The NICU nurses are trained to spot and manage any discomfort your baby may feel.
Follow-Up Eye Care
If your baby is diagnosed with ROP in the NICU, you’ll need follow-up care even if your baby doesn’t need treatment. You’ll have an appointment with the eye doctor again a few months after your baby leaves the hospital.
Any stage of ROP may make your baby more likely to have nearsightedness, lazy eye, and crossed eyes in the future.
Retinopathy of Prematurity FAQs
ROP isn’t something most new parents thought they’d have to deal with. You probably have a lot of questions. Here, we answer some of the most frequently asked questions.
What is retinopathy?
Any growth of abnormal blood vessels at the back of the eye (near the retina) is called retinopathy. It can be caused by many things, like diabetes, infections, hypertension, and some kinds of treatments. Premature infants are one of the groups most likely to experience it.
Which babies are most at risk?
All premature babies born weighing under 3.3 lbs or born before 31 weeks are considered at risk for retinopathy of prematurity. Your baby is more likely to have ROP if they:
- Are male
- Took supplemental oxygen for a long time
- Weren’t able to grow properly in the womb
- Have anemia
- Have an infection
- Got blood transfusions
- Have some types of heart conditions
How common is ROP?
Almost half of all premature babies have some degree of ROP. Only about 10% of those will need treatment.
What are the zones and stages of ROP?
ROP’s progress is noted by zones and stages. The zone means where it’s occurring. The stage means how bad it is.
- Zone 1 is the centermost point of the eye.
- Zone 2 is around the center.
- Zone 3 is around the outer edge of the retina.
Zone 1 is the most serious, and zone 3 the least.
There are 5 stages of ROP. Stage 1 has the least damage. Stage 5 is when the retina is detaching. Most of the time, doctors won’t recommend treatment until it gets to stage 3.
What are the symptoms of ROP?
One of the scariest things about ROP is that there are no symptoms. That’s why all babies who might be at risk get screened in our NICU. If your baby is able to leave the hospital before getting screened, we’ll make an appointment to check them.
It’s very important that you take your baby to this appointment since there aren’t any symptoms of ROP.
Will my child have lasting vision problems?
Premature infants are already more likely to have vision problems. Things like nearsightedness, crossed eyes, and glaucoma show up more often and earlier in children born prematurely. Regular eye exams can help catch these issues quickly.
Can ROP be prevented?
No one wants to give birth prematurely. Unfortunately, sometimes it can’t be prevented. We’ll do everything possible to limit factors we know can increase your baby's risk of ROP.
For instance, we have fine control over how much oxygen we give with our machines.
But often, ROP will still occur. The best thing we can do is detect it early and treat it promptly.
Support for Families
For many, ROP is one of the first issues found in the NICU. That brings with it a lot of emotions. We have resources for you during this time. Please let your child’s nurse know if you’re feeling overwhelmed. We can get you support.
Some of the support we have for NICU families includes:
All of these resources can help you communicate your care plan, get you to what you need, and help you understand your child’s treatment.