ROP Screening for Premature Babies

The blood vessels that feed the retina finish growing in the last months of pregnancy. A baby born early arrives before that job is done.

Outside the womb, those vessels can grow the wrong way. In severe cases they form scar tissue that pulls the retina away from the back of the eye, causing permanent blindness.

Most ROP is mild and settles on its own. Screening exists to catch the few cases that get worse, while treatment still works.

In India we screen a wider range of babies than many other countries do, because bigger and more mature babies here have been found to develop ROP. Using other countries' cut-offs would miss cases.

Screening is needed for babies born early or with a low birth weight. We widen that further if there were other problems — long time on oxygen, infection, breathing difficulties, blood transfusion, or slow weight gain.

Your baby's doctor will tell you what applies. If there is any doubt about whether screening is needed, screen.

A missed appointment is the most common route to preventable blindness in this condition.

The date we give you is worked out from how fast your particular baby's eyes are changing. It is not a rough guide.

We put in dilating drops first. Then we look at the back of the eye with a bright light and a lens, using a small instrument to hold the lids and gently turn the eye so we can see the far edges — which is exactly where ROP starts.

It is quick, but it does upset the baby, and parents often find it hard to watch. We use comfort measures, and babies settle quickly afterwards.

• Laser treatment to the outer retina, which stops the abnormal vessels being driven to grow. Long established, with well-known results.
• Injection into the eye to block the signal driving the abnormal vessels. Useful in certain patterns, and needs careful follow-up afterwards.
• Surgery if the retina has already started coming away. Results are more limited — which is exactly why catching it early matters.

Babies treated for ROP need long-term eye check-ups. They have a higher chance of squint, glasses power and lazy eye later on.

Dr. Shah screens at partner newborn units across Ahmedabad — Sneh Children Hospital (Ranip), Apple Children Hospital (Gota) and Sunshine Children Hospital (Gurukul) — as well as at the clinic.