Retinopathy of Prematurity (ROP) occurs only to premature babies, it can cause blindness. There is need to always look out for its symptoms especially if one has had a premature baby. ROP has stages of severity thus the earlier detected the more chances of treatment. Your doctor would advise if corrective measures can be taken.

During the last three months, a baby’s eyes are well developed in the womb.  Thus the earlier a baby is born, the more chances of that baby developing ROP. According to Healthline.com, experts note that premature childbirth is responsible for 35% of instances vision impairment and 25% of instances of hearing impairments.

When a baby is born before 37 weeks of gestation or when the baby is born of low birth weight, there is a disruption in the growth of normal blood vessels in the eye. The blood vessels provide blood to the retina. ROP is caused when blood vessels grow abnormally in the retina.

These blood vessels grow randomly in the eye area. They could leak or bleed thus scarring the retina. When that occurs, the retina is pulled thus detaching from the back of the eye. This causes blindness. The retina is a tissue that underlines the back part of the eye. It enables us to see by transmitting visual information to the brain. When scarring occurs, it detaches from the back part of the eye.

Image from Prolacta Medical Science explaining Retinal Detachment

The other cause of this visual impairment in preemies could be extreme exposure to oxygen therapy while in Neonatal Intensive Care Unit, NICU. At birth, premature babies’ lungs are never fully developed, thus they are unable to breathe on their own. They have to be aided to breathe to maintain the 100% oxygen saturation level in the blood.

Extreme high levels of oxygen in the blood can damage the eyes leading to ROP.

According to American Association of Opthalmology and Strasbismus, supplemental oxygen used to treat respiratory distress syndrome of prematurity and bronchopulmonary dysplasia has long been associated with ROP.

Always consult with your doctor. They do monitor the oxygen levels the baby is exposed to in NICU.

Potential Complications of ROP Include;

  1. Crossed eyes (Strabismus) – This is misalignment of one or both eyes.
  2. Nearsightedness (Myopia) – This is the ability to see nearby objects. Anything far appears blurry or fuzzy.
  3. Farsightedness – (hyperopia)
  4. Lazy eyes (Amblyopia)
  5. Chronic tearing of the eyes
  6. White pupil instead of black (leukocoria)
  7. Abnormal eye movements (nystagmus)
  8. Glaucoma
  9. Blindness

Symptoms to look out for as a parent or caregiver include;

  1. Signs of vision problems
  2. Constant eye rubbing
  3. Extreme sensitivity to light
  4. Poor focusing
  5. Poor visual tracking – try to make your baby follow an object.
  6. Chronic redness of the eyes

ROP is hard to detect but a pediatric ophthalmologist is usually able to, by use of special instruments.

Prevention of Retinopathy of Prematurity

The best prevention is prenatal care to reduce the likelihood of premature birth.

Although doctors can’t prevent ROP, they can help prevent its most harmful effects through careful screening and treatment.

Read on a study of ROP conducted in Kenya, Published in 2018 to get the statistics for more information.

About 60% of the world’s preterm births occur in sub-Saharan Africa and Asia. In Kenya, pre-term births are estimated at 12.3%. With improved neonatal systems in developing countries, survival rates for premature infants have increased. Many of these infants survive with disabilities, including visual complications.

Retinopathy of prematurity (ROP) is now emerging as an important cause of ocular morbidity in low and middle income countries. Despite this, little is known about ROP in sub-Saharan Africa, Kenya included. Lack of information has hampered the development of screening programs that would aid early detection and treatment of ROP. ROP screening and treatment has been ongoing in Nairobi Hospital since 2010.

Survival rates for preterm infants is high and ROP has been identified as an upcoming epidemic in this hospital. This study was done to determine the prevalence and risk factors associated with ROP in a hospital with advanced neonatal care in a developing country. (Extract from)

https://www.panafrican-med-journal.com/content/article/29/152/full/

Further references on ROP include;

https://www.ucsfbenioffchildrens.org/conditions/retinopathy_of_prematurity/

https://kidshealth.org/en/parents/rop.html

https://en.wikipedia.org/wiki/Retinopathy_of_prematurity

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity

https://www.childrenshospital.org/conditions-and-treatments/conditions/r/retinopathy-of-prematurity-rop/symptoms-and-causes

https://pedclerk.bsd.uchicago.edu/page/retinopathy-prematurity

https://www.hopkinsallchildrens.org/patients-families/health-library/healthdocnew/retinopathy-of-prematurity

http://myeyecareplus.com/Strabismus-or-Crossed-Eyes_ep_56-1.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740273/

About Brenda S. Anyumba

Brenda is passionate about raising premature babies and finding solutions to save the increasing numbers of premature babies dying daily in Africa. She had a late preterm baby and an extremely preterm baby. Brenda is also keen on the training of children according to God's will. She reads on 'Kingdom Parenting' and practises the knowledge she learns on her boys and is blessed to share them with you too.

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