Patient education: Retinopathy of prematurity (The Basics)

What is retinopathy of prematurity? — 

Retinopathy of prematurity, or "ROP," is an eye condition that happens in babies who are born very early. In ROP, extra blood vessels grow inside the eye. They can damage the tissue at the back of the eye, called the "retina" (figure 1). The retina contains the cells that react to light. Damage to the retina can cause vision problems and even blindness.

ROP usually gets better as a baby grows. But if ROP is severe, some babies might need treatment.

What are the symptoms of ROP? — 

ROP usually does not cause symptoms. But doctors check for ROP in all babies who are born very early.

Is there a test for ROP? — 

Yes. An eye doctor can do an exam to check for ROP. Before the eye exam, the doctor or nurse will put drops in your baby's eyes to make their pupils bigger. This is called "dilating" the pupils. This lets the eye doctor see the retina clearly. Some hospitals check for ROP by taking pictures of the baby's eyes. They electronically send the pictures to an eye doctor who can tell if there are signs of ROP.

A baby might not need an eye exam until they are 4 to 8 weeks old. After the first exam, an eye doctor will probably check your baby's eyes every 1 to 3 weeks. They can check to see if the ROP is getting worse or better. If it gets worse, your baby might need treatment.

How is ROP treated? — 

Some babies do not need any treatment. But severe ROP needs treatment, or it can cause blindness.

There are 2 procedures doctors can use to treat ROP:

●Laser photocoagulation – This uses a powerful light called a "laser" to seal or destroy the extra blood vessels. Babies often need general anesthesia for this procedure. This involves giving medicine to put the baby to sleep so they won't move or feel anything during the procedure.

●Anti-VEGF injection – This involves injecting the eye with special medicines called "anti-VEGF" drugs. They stop the extra blood vessels from growing. Most babies don't need general anesthesia for this procedure. The doctor uses a numbing medicine on the eye before the injection.

The doctor will talk to you about which procedure is right for your baby, depending on their condition and how severe their ROP is.

Sometimes, ROP pulls the retina out of its normal place in the eye. When this happens, it is called a "retinal detachment." Doctors can do surgery to try to put the retina back in place. But there might be too much damage for surgery to fix it completely. If this happens to your baby, they might not see well from that eye.

Can ROP be prevented? — 

Doctors do not currently have a good way to prevent babies from getting ROP. Feeding your baby breast milk can help protect them from getting it. Breast milk has other benefits for babies, too.

If your baby needs eye exams to check for ROP, go to all the appointments. This way, your baby can get treatment for ROP if they need it.

More on this topic

Patient education: What to expect in the NICU (The Basics)
Patient education: When a baby is born premature (The Basics)
Patient education: Benefits of breast milk for premature babies (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)