Timing of first eye examination for retinopathy of prematurity based upon gestational age at birth

GA at birth (weeks)	Age at initial examination
GA at birth (weeks)	Postmenstrual age (weeks)	Chronologic age (weeks)
22*	31	9
23*	31	8
24	31	7
25	31	6
26	31	5
27	31	4
28	32	4
29	33	4
30	34	4
Older GA with high-risk factors^¶	–	4

This table summarizes our suggested approach for the timing of the first ROP examination in preterm infants. ROP screening is suggested for all infants with BW ≤1500 g or GA ≤30 weeks, and for more mature preterm infants whose clinical course places them at increased risk for ROP (as determined by the neonatologist). The above schedule detects prethreshold ROP with 99% confidence, usually before any treatment is required.

ROP: retinopathy of prematurity; GA: gestational age; BW: birth weight.

* Because of the small numbers of survivors in these gestational categories, this guideline should be considered tentative rather than evidence-based.

¶ ROP screening may be warranted in more mature preterm infants whose clinical course places them at increased risk for ROP. This is generally determined by the neonatologist. Examples of high-risk factors include requiring mechanical ventilation for >1 week (especially with high oxygen concentration), high severity of illness score, and severe sepsis. Refer to UpToDate's topics on ROP for additional details. The timing of the first ROP examination may vary depending on the severity of comorbidities.

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Timing of first eye examination for retinopathy of prematurity based upon gestational age at birth