Retinopathy of Prematurity
What is retinopathy of prematurity?
Retinopathy of prematurity (ROP) is a condition that develops in some premature infants. Normally the blood vessels of the retina finish growing around 40 weeks of gestation when a baby is full-term. If a baby is born before 31 weeks, is very small or very sick, their blood vessels stop growing normally and in some cases can grow out of the retina causing serious problems for the eye and vision. ROP can go away on its own as the baby grows, but if it does not, the baby will require treatment.
What are the signs and symptoms of ROP?
Many of the signs of retinopathy of prematurity happen deep inside the eye, so a parent isn’t able to see them. Only an ophthalmologist who is trained to recognize and treat ROP, such as the experienced team at VitreoRetinal Surgery, can spot these signs through the use of special instruments that examine the child’s retina.
Since ROP develops in premature infants, the American Academy of Pediatrics has set ROP screening guidelines for all newborn intensive care units. The vast majority of infants with ROP are identified through those exams.
An infant with severe ROP may develop visible complications, such as nystagmus (abnormal eye movements) and leukocoria (white pupils).
How is ROP treated?
If the ROP does not go away after some time with close monitoring, treatment is necessary. This happens in about 10 percent of infants with ROP. The other 90 percent of infants have a mild form of ROP. There are a number of treatment options to stop the abnormal blood vessel growth and save the central vision, depending on the stage of ROP. Treatment options include laser, injection of medication or a combination of the two.
When is surgery necessary?
If ROP does not respond to treatment or if it progresses rapidly before treatment is started it can result in bleeding or retinal detachment. If this happens surgery may be necessary.
The most common surgery for severe ROP is vitrectomy. In a vitrectomy, the ophthalmologist creates a tiny incision in the child’s eye. Through this incision blood, scar tissue, and the vitreous gel is removed from the eye and replaced with saline solution or another alternative.
By removing the scar tissue, it no longer tugs on the retina, which stops it from pulling away. A vitrectomy for ROP infants can take several hours.
What is recovery like after a vitrectomy?
Vitrectomy requires the most involved recovery of any treatment for ROP. Full recovery takes between 4 to 6 weeks. Some patients may be required to lay face down for a period of time to help their eye heal properly.
Can ROP be prevented?
Because doctors are not sure of the exact causes of retinopathy of prematurity, it’s next to impossible to answer what could be done to prevent it. The best way to prevent problems with premature births is excellent prenatal care to reduce the likelihood of these premature deliveries.
What happens if ROP is left untreated?
In the vast majority of infants with retinopathy of prematurity the condition resolves itself without treatment. However, it still very important to have your child’s condition monitored regularly. After all, if the child is in that 10 percent of ROP patients whose eye continues to develop abnormal blood vessels, not treating the condition can lead to these complications:
- Scarring and/or dragging of the retina
- Retinal detachment
- Bleeding inside the eye