Retinopathy of prematurity (ROP) can occur in children who are born prematurely and who weigh 2.75 lbs or less at birth. This condition occurs when abnormal blood vessels grow in the light-sensitive layer of tissue at the back of the eye, called the retina. Abnormal blood vessels can develop scar tissue that can lead to retinal detachment which causes vision impairment or blindness. The blood vessels in the retina typically develop at about the fourth month of pregnancy and don’t finish developing until about the ninth month of pregnancy, shortly before birth. Because of this, babies who are born prematurely may not have fully developed retinal blood vessels, with an increased risk of developing retinopathy of prematurity the earlier they are born.
Signs, Stages, And Treatment Of Retinopathy Of Prematurity
Signs Of Retinopathy Of Prematurity
There are no outward signs of retinopathy of prematurity until your child is older. If your child was born prematurely (or very underweight) and you notice that their eyes shake or make other odd movements, their pupils look white, they have trouble recognizing faces, or their eyes don’t follow objects, they may have been born with ROP. If you notice any of these signs, take your child to the optometrist. These same symptoms can also be indicative of other eye conditions including retinoblastoma, pediatric cataracts, congenital glaucoma, and more.
Stages Of Retinopathy Of Prematurity
The stages of this condition range from mild (stage 1) to severe (stage 5). Stages 1 and 2 are monitored by doctors but they often resolve themselves and the child will begin to develop healthy, normal vision. If the child progresses to stage 3, they are at risk of developing retinal detachment and should receive treatment to prevent this, but they still have a high chance of developing good vision after this retinal treatment. For a child to be considered to have stage 4 ROP, their retina will be partially detached and they will need treatment. At stage 5 retinopathy of prematurity, the retina is fully detached and treatment is recommended as soon as possible. Babies with stage 5 ROP may have permanent vision impairment or blindness.
Treatment Options
Many children who are born with retinopathy of prematurity will have mild cases that will naturally resolve as the child develops, especially if they were born only slightly prematurely. However, children who are born very premature will likely need to receive treatment.
- Laser Treatment
By focusing a laser on the small area where abnormal blood vessels are growing, the ophthalmologist cauterizes these blood vessels to stop growth and prevent the condition from worsening. - Injections
Anti-VEGF drugs can be injected into the eye to stop the growth of abnormal blood vessels. - Eye Surgery
Children with stage 4 or 5 retinopathy of prematurity will need scleral buckle surgery or a vitrectomy.- Scleral buckle surgery temporarily places a flexible band around the white of the eye to support the detached retina until the eye grows properly. Once the eye has healed, the flexible band can be removed.
- A vitrectomy removes any scarring on the retina and some of the gel-like fluid (the vitreous) within the eye. This fluid is replaced with a saline solution and the retina is secured into place.
Treat Retinopathy Of Prematurity And Monitor Your Child’s Vision
If your child has or used to have retinopathy of prematurity, they should receive regular eye exams going forward. Although many children recover from this condition without treatment, retinopathy of prematurity does increase their risk of developing other conditions that can be treated by an optometrist. To monitor your child’s vision and ensure proper eye health and development, schedule regular comprehensive eye exams with My Optometrist. Our optometrists will search for complications related to retinopathy of prematurity and will offer personalized treatment plans for any related eye conditions. To book an eye exam with one of our eye doctors, contact My Optometrist at one of our three locations at Health First in SE Calgary, Sunridge in NE Calgary, or Three Hills, AB. You can also call us or fill out the online contact form.
FAQ
Q: When should my child go to the optometrist?
A: You should take your child for their first children’s eye exam when they are 6 months old. Another children’s eye exam is recommended again at 3 years old, and another at 5 years old. After that, it should be an annual routine. Once a person reaches young adulthood, at approximately 19 years of age, it may be advised to transition to bi-annual exams or as recommended by your optometrist. Learn the importance of children’s eye exams by reading Children’s Eye Exams At Different Ages.
Q: Does a retinal detachment always lead to blindness?
A: Not necessarily. If the retina is detached and cut off from the blood supply for long enough, it will die and vision will be lost. However, if the retina is reattached in time, the retina can heal and vision can be restored. Learn more about retinal detachment by reading How Is Vitreous Detachment Related To Retinal Detachment?
Q: What is included in an infant eye exam?
A: Most infant eye exams include vision testing, eye health evaluation, eye alignment testing, and prescription of eyewear if necessary.