Retinopathy of Prematurity
ROP

Retinopathy of prematurity (ROP) occurs in premature babies when abnormal blood vessels and scar tissue grow over the retina.  The retina is the light detecting layer of cells at the back of the eye that allows us to see.  This condition usually affects premature babies weighing less than three pounds at birth.  An ophthalmologist can detect ROP during an examination of the baby’s eyes in the neonatal intensive care unit (NICU) or nursery.

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WHAT CAUSES ROP?
There are multiple causes of ROP.  The two most common causes are gestational age and low birth weight. Other contributing factors may be Brain hemorrhage, underdeveloped lungs, systemic infection, poor circulation to the eyes, poor organ function and excessive oxygen that is given to assist breathing. 

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WILL ROP AFFECT VISION?
It is difficult to predict whether the eyesight will be affected when the diagnosis of ROP is made. In many infants, the abnormal blood vessels shrink or go away without infecting vision. In others with more extensive disease, bleeding and scar tissue may lead to distortion or detachment of the retina.  Moderate or even severe loss of vision may result. Only a very small percentage of babies become blind. Nearsightedness (myopia) is common in children with ROP.  Glasses may improve the vision of these children, unless the eye is badly damaged. Amblyopia (lazy or crossed eyes) is more common in children with ROP.

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CAN ROP BE PREVENTED?
Unfortunately, laboratory and clinical research has not yet found a way to prevent ROP in all babies.  The sophisticated medical care provided in modern neonatal intensive care units has improved the survival chances of very small babies.  Because more premature infants survive, ROP has become more common.

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CAN ROP BE TREATED?
Most babies’ eyes with ROP do well without any treatment.  In more severe cases, your ophthalmologist may use laser treatment or cryotherapy (freezing) to treat the outer parts of the retina that are affected.
When successful, treatment can slow down or reverse the abnormal growth of blood vessels and scar tissue in more severe ROP.  Treatment significantly lowers the chance of severe vision loss.  It may be necessary for an ophthalmologist to examine a baby frequently while the infant is in the NICU or nursery before treatment can be recommended. Even with treatment, there is still risk of serious vision loss.  The long-term effects of cryotherapy and laser treatment for ROP are being studied.  More complex surgical procedures can sometimes restore limited vision if severe ROP disease pulls the retina out of place (retinal detachment).  Other ROP complications such as glaucoma and misaligned eyes may also require surgery later in life.
Periodic eye examinations will be necessary as the baby grows, to ensure that his or her vision is developing as normally as possible.