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Understanding Retinopathy of Prematurity (ROP): Causes, Diagnosis, and Treatment
Medically reviewed by Tina Patel, Contact Lens Optician at Feel Good Contacts on 14/06/2023.
- What is retinopathy of prematurity (ROP)?
- ROP risk factors
- What are the symptoms of ROP in newborn?
- ROP causes
- How is retinopathy of prematurity Treated?
- Surgical interventions for ROP
- How is ROP diagnosed?
- Long-term effects and follow-up care
- ROP prevention strategies
This article discusses what retinopathy of prematurity (ROP) is, it explains the causes of this condition, the diagnosis steps and ROP treatment options.
What is retinopathy of prematurity (ROP)?
Retinopathy of prematurity (ROP) is a premature baby eye condition that can occur in babies that are born too early, or in babies that weigh less than 3 pounds.
This condition causes abnormal blood vessels to grow in the wrong direction within the retina which can then leak, causing scarring. If the blood vessels grow too far in the wrong direction they might pull the retina which can lead to a detached retina, causing vision loss and blindness in some cases.
ROP risk factors
Risk factors for retinopathy of prematurity include:
- Immaturity
- Low birth weight
- Low gestational age
- Oxygen administration
- Apnoea
- Thrombocytopenia
- Jaundice
What are the symptoms of ROP in newborn?
This retinal blood vessel growth disorder has no symptoms when it first develops, in the early stages it can only be diagnosed by an ophthalmologist. Below are some of the symptoms an infant can encounter when they have ROP:
ROP causes
The blood vessels start growing in a baby from 16 weeks (whilst still in the womb) and only finish growing after the baby is born, so if a baby is born prematurely, this can cause abnormal growth.
How is retinopathy of prematurity treated?
Sometimes cases of ROP are mild enough to be left alone to resolve on its own, in mild cases the baby will be monitored to ensure the condition doesn’t get any worse. Moderate to severe cases may require surgery, especially if the scarring risks causing the retina to detach. This eye condition in premature infants can be treated by:
Laser therapy for ROP involves burning the sides of the retina with the laser to preserve the central vision. Cryotherapy for ROP involves using an icy cold instrument to kill specific parts of the retina. If medication is used as treatment, the medicine will be injected into the eye.
Surgical interventions for ROP
Below are the various surgical options for treating ROP.
Scleral buckle surgery
Scleral buckle surgery is when a flexible band is placed over the sclera. This band gives support to the detached retina, allowing the eye to start growing normally again. Once normal growth has resumed, a doctor will remove the band.
Vitrectomy
Vitrectomy involves making a small opening in the wall of the eyes to remove most of the vitreous fluid within the eye and replace it with saline solution. Scar tissue is then removed from the retina.
All treatment options are designed to stop the excessive growth of blood vessels and preserve vision, the best treatment option will be discussed with the ophthalmologist and the parent.
How is ROP diagnosed?
A ROP diagnosis is given by an ophthalmologist; they will need to look at the baby’s eyes. The baby’s pupils will be dilated using drops and then the retina will be examined.
Long-term effects and follow-up care
Even with surgical intervention, sight loss or blindness can still occur in infants with this condition. The child may have to be monitored for some time to ensure the condition doesn’t worsen. Regular eye tests will also likely be needed, this will be discussed with your optician.
ROP prevention strategies
The best way to prevent ROP is to prevent premature birth, this isn’t always possible as complications can still happen. There are certain things that can be done to reduce your chance of an early birth:
- Eat a healthy diet
- Minimise stress
- Avoid smoking and alcohol
- Try not to gain too much or too little weight
References:
www.nei.nih.gov. (2019). Retinopathy of Prematurity | National Eye Institute. [online] Available at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity
Kidshealth.org. (2018). Retinopathy of Prematurity (for Parents) - KidsHealth. [online] Available at: https://kidshealth.org/en/parents/rop.html
American Academy of Ophthalmology. (2018). What Is Retinopathy of Prematurity (ROP)? [online] Available at: https://www.aao.org/eye-health/diseases/what-is-retinopathy-prematurity
Wikipedia Contributors (2019). Retinopathy of prematurity. [online] Wikipedia. Available at: https://en.wikipedia.org/wiki/Retinopathy_of_prematurity
