Retinopathy of Prematurity

What is retinopathy of prematurity?

Premature babies can face a number of health problems and one of the more common is called retinopathy of prematurity (ROP). ROP causes abnormal blood vessels to grow in the retina, the layer of nerve tissue in the eye that enables us to see.

How is retinopathy of prematurity diagnosed?

Generally, the earlier a baby is born, the greater the risk of ROP. Because ROP has no signs or symptoms, the only way to detect it is through an eye examination by a pediatric ophthalmologist.

Nemours Advances the Screening and Treatment of ROP

In Florida, eye doctors at Nemours Children's Clinic, Jacksonville, have developed a single-use sterile exam kit for performing retinopathy exams. This kit, now used in 31 state and 60 Neonatal Intensive Care Units across the country, makes ROP testing safer and lessens the chance of infection.

And in Delaware, team members in the Division of Ophthalmology at Nemours/Alfred I. duPont Hospital for Children have published medical journal articles reviewing new guidelines on ROP screening and treatment, recent advances in therapies, and effective laser treatment options.

How is retinopathy of prematurity treated?

The results of your baby’s first eye exam will determine the need for and frequency of follow-up examinations. ROP is usually diagnosed according to stages that describe how far the blood vessels have grown into the retina.

Some cases of ROP are mild and correct themselves, but others require surgery to prevent vision reduction or blindness. Surgery involves using a laser or other means to stop the growth of the abnormal blood vessels,  the goal being to prevent the vessels from pulling on and detaching the retina.

Because there are varying degrees of ROP, the surgical approach used can differ for each case. We will discuss your baby’s condition with you and which method we recommend. The most frequently used method of ROP surgery is:

• laser surgery, in which small laser beams are used to scar the peripheral retina (also called laser therapy or photocoagulation). This procedure lasts about 30 to 45 minutes for each eye.

For more-advanced cases of ROP where retinal detachment has occurred, these methods are used:

• scleral buckling, which involves placing a flexible band, usually made of silicone, around the circumference of the eye.
• vitrectomy, a complex surgery that involves replacing the vitreous, or the clear gel in the center of the eye, with a saline (salt) solution.

Babies who’ve required any kind of treatment for ROP will need regular, long-term follow-up care. You can count on us to be with you every step of the way, and, if necessary, to provide recommendations for any vision-related services your child may need in the years to come. 

Learn more about retinopathy of prematurity from Nemours experts at KidsHealth.org.