Retinopathy of Prematurity (ROP)

Premature babies are at risk of ROP. This is a problem that can affect eyesight. ROP is the growth of abnormal blood vessels on the retina (lining of the back of the eye). In severe cases the blood vessels can detach the retina from the back of the eye.

Normal blood vessels form a delicate web on the retina.

With ROP, blood vessels can become large and twisted. They can form a ridge of scar tissue, or pull on the retina, causing it to detach.

What Causes ROP?

ROP occurs because the blood vessels on the retina are not finished growing until late in pregnancy. If a baby is born premature, these blood vessels aren’t fully developed at birth. So the blood vessels complete their growth after the baby is born. Factors in the environment outside of the womb may cause them to grow abnormally. One problem may be changing levels of oxygen in the blood. ROP is more likely in younger or smaller preemies.

How Is ROP Diagnosed and Monitored?

All premature babies in the NICU (neonatal intensive care unit) have their blood oxygen levels closely monitored. Babies born under 32 weeks gestation or weighing under 1,500 grams are examined by an ophthalmologist (eye doctor). Eyedrops are used to dilate (expand) the pupil of the eye. This allows the doctor to look through the pupil to check the blood vessels on the retina. If the doctor sees abnormal blood vessels, the ROP is rated from stage 1 (mild) to stage 5 (severe). The location of the blood vessels is also noted. The first exam may be done around 4–6 weeks after birth. Depending on the results of this exam and the baby’s gestational age, follow-up exams may be needed.

How Is ROP Treated?

Mild ROP (stages 1 and 2) often needs no treatment. Babies with moderate to severe ROP may need laser surgery. The surgery uses lasers to seal abnormal blood vessels. This prevents the blood vessels from growing and causing further damage. Laser surgery is often effective. It is not likely to cause complications.

What Are the Long-Term Effects?

Many babies with ROP have no lasting effects. The more severe the disease, the more likely that it will lead to permanent vision problems. The baby’s vision will most likely need to be evaluated within 6 months after leaving the hospital, to see if glasses or eye exercises are needed. In rare cases, ROP can cause blindness.