Understanding Retinopathy of Prematurity (ROP): Causes, Symptoms, and Treatment Options

Retinopathy of Prematurity (ROP) is an eye disorder that primarily affects premature babies born before the 31st week of pregnancy and weighing less than 2 3/4 pounds. In the United States, approximately 14,000 babies are born with ROP each year, and 400 to 600 of them may become legally blind. However, most babies with ROP improve over time, and many do not require treatment.

What Causes Retinopathy of Prematurity?

A baby's eyes begin to develop around the 16th week of pregnancy. When a baby is born prematurely, this development process is interrupted, and the blood vessels in their eyes may not have enough time to develop properly. As a result, these blood vessels can grow abnormally or become fragile, leading to bleeding or leakage.

Symptoms of Retinopathy of Prematurity

ROP does not typically present noticeable symptoms, and only an eye doctor can diagnose the condition. All infants at risk for ROP should be screened shortly after birth and again once they are discharged from the hospital. In some cases, ROP may not be detected until the baby is 4 to 6 weeks old.

Diagnosing Retinopathy of Prematurity

To diagnose ROP, an eye doctor will dilate the baby's pupils using eye drops, allowing for a better view of the eye's internal structures. The doctor will then assess the location and severity of ROP and examine the appearance of the blood vessels in the eyes. ROP is classified into five stages, with stage 1 being the mildest and stage 5 being the most severe, potentially leading to blindness.

Treatment Options for Retinopathy of Prematurity

In many cases, ROP resolves on its own without the need for treatment. However, if the condition is severe and there is a high risk of retinal detachment, treatment may be necessary. Approximately 10% of babies screened for ROP will require treatment, which can include:

• Laser surgery: Small laser beams are used to treat the sides of the retina, preventing the growth of abnormal blood vessels. This is the most common treatment for ROP.

• Cryotherapy: An older treatment method that uses freezing temperatures to stop the spread of abnormal blood vessels on the retina.

• Injection: A newer treatment approach involves injecting an anti-cancer drug, such as bevacizumab (Avastin), into each eye to block the growth of new blood vessels.

If the retina is detached, more complex surgical procedures may be required, such as scleral buckling or vitrectomy. Although treatment often prevents the progression of ROP and vision loss, up to 25% of babies who undergo surgery for ROP may still experience some degree of vision loss.

Children with ROP have a higher risk of developing eye problems later in life. Therefore, it is crucial for them to have annual follow-up appointments with their eye doctor until adulthood. By understanding the causes, symptoms, and treatment options for ROP, parents can better support their premature babies and ensure they receive the necessary care for optimal eye health.

For more information on Retinopathy of Prematurity, visit:

• National Eye Institute - Retinopathy of Prematurity

• American Academy of Ophthalmology - Retinopathy of Prematurity

• March of Dimes - Retinopathy of Prematurity

The Bottom Line

Most premature babies with ROP recover completely without treatment, but early screening is critical since severe cases can cause blindness if missed. Parents of preemies should ensure their child receives proper eye examinations and continues regular follow-up care into adulthood. If you have concerns about your premature baby's eye development, Doctronic can help connect you with specialists quickly.