A Parent's Guide to the NICU

Retinopathy of Prematurity

What is Retinopathy of Prematurity?

Retinopathy of Prematurity (ROP) is abnormal growth of blood vessels in the baby's eye. It is most common in babies who are very premature, more than 12 weeks early. In development, blood vessels grow from the back central part of the eye out toward the edges. This process is completed just a few weeks before the normal time of delivery. In premature babies this process is not complete. If blood vessel growth proceeds normally, the baby does not develop ROP. If the vessels grow and branch abnormally the baby has ROP.

Why do premature babies get ROP?

We do not yet fully understand all the factors leading to ROP. We do know that it is the smallest and sickest babies who are at highest risk for ROP.

Does too much oxygen cause ROP?

In the 1940's and 1950's premature babies were often placed in oxygen whether or not they had lung problems or needed extra oxygen. Some of these babies developed Retrolental Fibroplasia, a condition like advanced ROP. Today oxygen is carefully monitored so babies get the right amount of oxygen into their blood, not too little or too much.

How will my doctors know if my baby has ROP?

If your baby is at risk for ROP, your baby's eyes will be checked by an ophthalmologist, a doctor specializing in eye problems. These exams start at about 4-8 weeks of age and occur regularly until the eye vessels have grown to the edges.

What happens if my baby has ROP?

If the ophthalmologist sees any abnormal growth of blood vessels, s/he will record the extent of ROP, called Staging. Infants who have ROP are followed with more frequent eye exams to watch for any progression.

How is ROP treated?

Stage I and early Stage II do not usually need any treatment. These stages may resolve on their own without further progression. Infants with Stage III may require treatment to stop the progression of the abnormal vessels. Laser treatment prevents further abnormal growth of the blood vessels. This helps prevent the inner lining (retina) from being pulled away (detached) from the outer lining by the abnormal vessels.

Are there long term effects of ROP?

Premature infants more frequently need glasses in early childhood than children who were not premature. This may be the case even if your child did not have ROP, but it is more common in those with ROP. It is also possible to develop "lazy" eye (amblyopia) or wandering eye (strabismus). Severe ROP can lead to blindness. Treatment of ROP decreases the chances for blindness, but it does not always prevent it.

For more information on ROP, follow the link to ROPARD.org.