Retinopathy of Prematurity

19th May 2016

The back part of the eye is called the Retina. It receives light and sends visual signals to the brain. The eye develops very quickly in the last 12 weeks of pregnancy, therefore a baby born early has eyes that are still developing and is at risk of the blood vessels not growing normally.

If the blood vessels do not grow normally they can detach the retina and cause severe visual problems (Retinopathy of Prematurity). It is because of this that the developing retina is monitored in a baby’s eyes.

Who needs eye checks?

All premature babies born at 30 weeks gestation or earlier and all babies weighing 1,250 grams or less will need eye checks. Also some other babies who were born after 30 weeks but before 32 weeks gestation will need to be screened if they have been unwell or the doctor is concerned.

What does the eye check involve?

The eye check involves eye drops being put into each eye at least 30 minutes before the eye check. These drops will numb the eye and dilate the pupil to allow us to take photographs of the back of the eye.

Once the pupils are dilated, a machine, similar to an ultrasound machine is used to take photographs of the eye. 

An ophthalmologist (eye doctor) will look at the photographs, and if there are any concerns the ophthalmologist and/or the neonatologist will let the parents know.

Does it hurt?

It doesn’t appear to hurt but it will be uncomfortable for a short period of time. Babies are given some oral sucrose or expressed breast milk for comfort, and a cuddle from parents helps once the test is finished.

How often will it need to be done?

The eyes will need to be checked every two weeks until the baby’s retina has reached full maturity (approximately when your baby was due to be born). 

What if something is wrong?

Retinopathy of Prematurity (ROP) and it has several different stages. Mild ROP stage I or II generally resolves on its own, more advanced ROP may need treatment with laser surgery.

If a baby has ROP, NICU staff will closely monitor this every week, if a baby needs laser treatment this is also discussed with the parents.

Although it is rare to have a baby with severe ROP monitoring of all babies is still required so that that one baby with any problems isn't missed. If a baby has any stage of ROP they will require follow up at approximately 4 months of age. 

What if a baby needs Laser treatment?

If a baby has ROP that needs to be treated, the opthalmologist and neonatologist will meet with parents discuss Laser treatment. The opthalmologist does this treatment in theatre.

Following Laser a baby will need to be cared for in the Intensive Care area of the nursery as babies may take some time to recover from both the surgery and the anaesthetic. If a baby needs Laser treatment it will be done within 2-3 days of recognising the need for surgery. This is to make sure the baby is treated before the ROP progresses.

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