Retinopathy of Prematurity is an eye condition that affects the eyes of premature infants. Eye blood vessels continue to develop until birth. In early births, these vessels continue their development after birth. Premature infants need to be kept in incubators. During this time, exposure to high levels of oxygen can cause abnormal development of the eye blood vessels. As a result, premature infants who are born before their eye vessels are fully developed may develop Retinopathy of Prematurity, shortly known as ROP, which can lead to blindness if not treated in time. Therefore, early premature infants must be examined by an ophthalmologist between 4-6 weeks of age. Subsequent examinations are repeated every 1-2 weeks until the normal term if the disease is not present.
How is a ROP Examination and Treatment Done?
ROP examination involves enlarging the pupils under topical anesthesia to examine the retina, the nerve layer of the eye. The most crucial step in treating ROP is regular monitoring. ROP resolves spontaneously in 80% of cases, while treatment is necessary in 20%. Treatment proceeds from mild to severe depending on the stages of the disease.
In the initial stage, only monitoring is sufficient. In issues that have reached the third stage, the most common treatment method is laser therapy. With laser application, damaged blood vessels in the eye are eliminated. In cases that are not detected in time and continue to progress despite laser treatment, vitrectomy surgery is performed, but treatment at this stage may not always yield desired results.
Outcomes of ROP Disease
ROP disease can lead to blindness as the worst outcome. Blindness is the most undesired result occurring in cases that are neglected or treated too late. If monitoring and treatment are done without excessive delay, blindness does not develop.
ROP, a condition resulting from advancements in medical technology allowing premature infants to survive, has been somewhat controlled. For healthy babies and future generations, ensure your premature infants are examined by an ophthalmologist.
Parental Responsibilities in Monitoring Premature Retinopathy (ROP)
Retinopathy of prematurity (ROP) is a common and serious threat to eye health in preterm infants. In addition to the diagnosis and treatment process, it is extremely important for parents to be conscious and sensitive about monitoring the disease. In this process, parents should not miss regular check-ups and should carefully follow the doctor's recommendations. Doctor-recommended monitoring intervals during an ROP examination process are crucial for maintaining the infant’s eye health.
Retinopathy of prematurity develops due to abnormal vessel growth after birth, generally starting in the first weeks after birth. Therefore, the first eye examination should be conducted between 4-6 weeks after birth, rather than immediately after birth. Delay in timely ROP examination could lead to irreversible vision loss in the future.
Importance of Early Diagnosis
Early diagnosis can prevent the progression of ROP disease. If any abnormalities are detected during the first examination, regular monitoring by a specialist is required. Laser application, anti-VEGF injections, or surgical methods like vitrectomy can be considered in treating retinopathy of prematurity in advanced stages. Effective treatment options require timely diagnosis of ROP.
Not every premature infant will develop ROP. The presence of risk factors (such as early gestational age, low birth weight, prolonged oxygen therapy) increases the likelihood of developing this disease. Avoiding an eye examination under the notion “my child has no symptoms” can be a big mistake. Ensuring the eye health of every prematurely born infant is a crucial parental responsibility for a healthy future.
Frequently Asked Questions
What is Retinopathy of Prematurity (ROP)?
Retinopathy of prematurity (ROP) is a severe eye condition observed particularly in babies born before 32 weeks of gestation or with a birth weight of less than 1500 grams. The retina is a light-sensitive layer at the back of the eye that facilitates vision. Normally, retinal blood vessels complete their development in the later weeks of gestation, but this is not the case in premature births. This can lead to the development of abnormal vessels, which may cause complications such as bleeding, retinal detachment, and permanent vision loss. ROP is a potentially dangerous condition that could result in blindness if not treated. Early diagnosis and appropriate treatment can largely prevent this risk.
How is a Retinopathy of Prematurity Examination Done?
A retinopathy of prematurity examination is conducted by a specialist eye doctor (pediatric ophthalmologist or retina specialist) involved in the neonatal intensive care process. During the examination, special drops are instilled to dilate the infant's pupils adequately in about 30-60 minutes. Subsequently, after anesthetizing the eye with topical anesthetic drops, the retina is examined in detail using special tools (retinoscope or indirect ophthalmoscope). If necessary, retina photos may be taken using imaging devices. This procedure usually takes a few minutes and is conducted with nurse assistance, ensuring calming measures for the infant's safety. The general condition of the infant is also taken into account during the examination.
When Should an Eye Examination Be Performed?
The first eye examination for ROP screening in premature infants should be conducted between 4 to 6 weeks after birth or when the gestational age is 31-33 weeks (whichever comes first). This examination is critical for detecting ROP at an early stage. Based on the first examination result, the doctor will determine the follow-up frequency. Even if no disease is detected, follow-ups continue until the normal development of retinal blood vessels is complete. If the disease is detected, the risk of progression is assessed and treatment planning is made if necessary. This follow-up process can sometimes be planned weekly or at shorter intervals.
What Happens if Retinopathy of Prematurity (ROP) is Not Treated?
In advanced stages of ROP disease, abnormal vascular structures can lead to intraocular hemorrhages and retinal detachment (retina decollement), resulting in serious vision loss. The risk of blindness is particularly high in untreated advanced stage (Stages 4 and 5) ROP cases. However, these risks can be significantly reduced when diagnosed early and treated appropriately. Treatment options include laser photocoagulation, intravitreal injections (anti-VEGF), and surgical interventions in advanced cases. If severely neglected, vision loss can become permanent, severely affecting the quality of life. Therefore, regular eye examinations for premature infants and timely initiation of treatment in risky situations are crucial.