What is Retinopathy of Prematurity?

D. Jeffress

Retinopathy of prematurity is a common eye disorder that affects premature babies. It occurs because blood vessels in the eye do not have time to fully develop before birth, resulting in blood leakage, blurry or nearsighted vision, and occasionally blindness. Neonatal care doctors typically screen all premature infants for the disorder. When retinopathy of prematurity is recognized very soon after birth, clinical treatments to freeze or cauterize blood vessels can be performed before they cause serious complications. Most babies experience full recoveries and do not have lasting vision problems.

Retinopathy of prematurity occurs when blood vessels in the eye aren't fully developed, a condition often seen in premature babies.
Retinopathy of prematurity occurs when blood vessels in the eye aren't fully developed, a condition often seen in premature babies.

Blood vessels in and around the retina begin to develop around the 16th week of gestation, and they continue to grow throughout a normal nine-month pregnancy. If an infant is born very prematurely, typically at the 30-week mark or earlier, the risk of retinopathy of prematurity is high. In the case of a premature birth, underdeveloped blood vessels begin to proliferate abnormally in the clear space in front of the retina. They can potentially cause tissue scarring that detaches the retina and leads to blindness.

The risk of retinopathy of prematurity is high for infants born sooner than 30 weeks of gestation.
The risk of retinopathy of prematurity is high for infants born sooner than 30 weeks of gestation.

The symptoms of retinopathy of prematurity depend on the severity of the condition. Infants who have mild disorders may not show any physical symptoms, and blood vessel proliferation may only be discovered during standard eye screenings. If the condition is severe, a baby may have crossed eyes, white-tinted pupils, and obvious problems focusing or controlling eye movements. Other symptoms of prematurity, such as breathing problems and slow heart rate, usually accompany the eye disorder.

Premature babies are usually screened for retinopathy of prematurity when they are about one month old. A doctor uses a specialized type of microscope to peer into the eye. He or she tries to identify abnormal blood vessels, check for scar tissue, and determine if retinal detachment has occurred. Depending on the severity of the disorder, a doctor may decide to wait and schedule a future screening or arrange for surgical treatment right away.

The most commonly used treatment for mild versions of retinopathy of prematurity is cryotherapy. A surgical specialist uses a liquid nitrogen probe to freeze blood vessels and stop their growth. A similar procedure can be performed using a laser to cauterize the vessels. If eye exams reveal signs of tissue scarring and retinal detachment, surgery is needed to excise blood vessels and reattach the retina. Modern advancements in eye surgery give babies the best possible chances of recovery with minimal risk of complications.

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