Retinopathy Of Prematurity

Retinopathy of prematurity (ROP) is an eye disorder of premature infants with abnormal growth of blood vessels in the retina. Severe ROP may cause blindness and long-term vision issues. Since it has no noticeable symptoms, detection is only possible through an eye examination. 

However, ROP is a treatable condition with early detection and treatment. Most cases of mild retinopathy of prematurity may resolve with no long-term vision problems.

Types of Retinopathy of Prematurity

Ophthalmologists classify ROP in stages as per the severity of the condition. The classification helps them decide the treatment options.

• Stage 1- The growth of blood vessels in the retina is mildly abnormal.
• Stage 2- The abnormal growth of blood vessels in the retina is moderate.   
• Stage 3- The growth of abnormal vessels is severe.
• Stage 4- The detachment of the retina is partial.
• Stage 5 - There is a complete detachment of the retina, causing serious vision issues or blindness.

Symptoms of Retinopathy of Prematurity

ROP has no visible symptoms as the changes and abnormalities are deep within the eye. These changes are only detectable using special eye instruments by an ophthalmologist. Other minor symptoms may go unnoticed by parents and NICU staff. However, the following symptoms may appear in premature babies having severe retinopathy of prematurity.

• Nearsightedness
• Strabismus (improper alignment of eyes)
• Leukocoria (white pupils)
• Nystagmus (Abnormal movements of the eyes)

What Causes Retinopathy of Prematurity?

Retinopathy of prematurity is one of several complications of low birth weight of premature babies. Hence, some researchers believe excessive exposure to oxygen to support the immature lungs of the newborn may increase the risk. 

Other causes of retinopathy include slow heart rate, seizures, and high amounts of free radicals in premature babies.

When to See a Doctor for Retinopathy of Prematurity

Premature babies form the at-risk population for retinopathy of prematurity. An eye exam can detect ROP at an early stage, so you should bring the following symptoms to the doctor's notice instantly:

• Misalignment of an eye
• Holding objects abnormally close to the eyes
• Crossing of eyes
• Squinting
• Showing unwillingness to use one eye
• Jerky eye movements
• Frequent rubbing of the eyes

What Is the Treatment for Retinopathy of Prematurity?

Babies having mild or moderate retinopathy of prematurity usually require no active treatment. However, ophthalmologists will conduct periodic eye examinations to ensure the condition is not worsening. Parents must not miss these appointments to monitor the baby's progress.

Treatment options for higher stages involve surgeries to arrest abnormal blood vessel growth, which may damage the retina. Multiple options are available in this case:

• Scleral Buckling is a surgery that lessens the tension inside of the eyeball. It helps reduce the damage to the retina because of scar tissue. 
• In Laser Photocoagulation, the surgeon uses a laser beam to burn the blood vessels likely to grow further. 
• Cryoretinopexy freezes the abnormal growth of blood vessels in the eye.
• The surgical procedure of vitrectomy is helpful if there is a significant amount of blood vessels and scar tissue. The surgery aims to prevent retinal detachment by removing a portion of the gel-like fluid with scar tissues within the eye.  

Conclusion

Retinopathy of prematurity (ROP) is the most common cause of vision problems in preemies and babies with significantly lower birth weight. Severe cases of ROP may cause permanent vision problems and blindness. Hence, newborn eye screening must be done to detect retinopathy of prematurity. Early detection, treatment, and regular eye examination may prevent vision loss. 

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