Pediatric Retina Service and Retinopathy Of Prematurity(ROP)

Pediatric Retina is a nascent subspecialty in Ophthalmology world over. Truly, it is Ophthalmology's newest 'Baby'. In the current scenario in India today, this niche specialty is evolving and only a handful of institutes have awarded it the status of a stand - alone department.

Over half of the world's blind children live in India alone. Approximately 24% of Childhood Blindness in India is Attributable to Retinal Causes. This is despite the fact that perhaps the most devastating causes of blindness stems from retinal diseases.

The growing numbers of premature infants surviving in India today have resulted in an epidemic rise of diseases such as Retinopathy of Prematurity ( ROP ). This needs urgent attention.

Retinopathy of Prematurity

Why should I worry about the eyes of a premature baby?

The inside of the eye, the retina is not fully developed in premature babies. Abnormal blood vessels can develop in such a retina. These abnormal blood vessels can cause internal bleeding and even retinal detachment. This is called Retinopathy of Prematurity ( ROP ). This condition results in low vision or blindness - both of which are irreversible.

How can we detect ROP ?

A trained ophthalmologist can Detect ROP by dilating the pupils of the eye using eye drops. An indirect ophthalmoscope is used to scan the entire retina to Detect ROP and gauge the state of retinal maturity.

Do all babies need a retinal examination for ROP ?

Babies with a birth weight of less than 1700 grams or those born in under 35 weeks of pregnancy are most likely to have ROP. Pre - term babies who have had problems after birth such as lack of Oxygen, Infections, Blood Transfusions Breathing Trouble, etc., are also vulnerable.

Is it too late for my baby's eyes ?

Follow the "Day - 30" strategy. The retinal examination should be completed before "Day - 30" of the life of a premature baby. It should preferably be done earlier ( at 2 - 3 weeks of birth ) in very low weight babies ( 1200 grams birth weight ).

What is the treatment for ROP ?

ROP is treated with Laser rays or a Freezing Treatment ( Cryopexy ). The treatment helps stop further growth of abnormal vessels thus preventing vision loss.

How often should the retina be examined ?

ROP can progress in 7 - 14 days and therefore, needs a close follow - up till the retina matures.

When should we treat ROP ?

ROP needs to be treated as soon as it reaches a critical stage called Threshold ROP. There is 50% or greater risk of vision loss if left untreated after this. Time is crucial!

After treatment

If treated in time, the child is expected to have reasonably good vision. All premature babies need regular eye examinations till they start going to school. They may need glasses or treatment for Lazy Eyes / Cross - Eyes and Sometimes, for Cataract, Glaucoma and Retinal Detachment.