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Retinopathy of Prematurity (ROP)
Timely treatment preserves baby’s vision
Ayesha Begum brought her baby to L V Prasad Eye Institute in 2004 when she was just 45 days old. Premature babies
with low birth weight are at great risk of having eye problems, as their retina is not fully developed at birth. The baby was
referred to the Retinopathy of Prematurity (ROP) services. The eyes seemed normal and the parents expected it to be a
simple eye check-up. But after extensive evaluation, including examination under anesthesia, doctors discovered a
severe threshold of ROP in both eyes.
To convince the parents that the baby had a serious vision-threatening condition, fundus photographs were taken with a
digital camera called RetCam that can take photographs of such tiny eyes without the need for sedation (Fig. 1). The
parents immediately understood that there was something wrong and consented to laser treatment. Two weeks after
multiple sessions of treatment with a diode laser, the left eye had healed completely. However, the right eye continued to
show progression of ROP. An elevation had started to develop in the peripheral part of the eye that was more than 6 clock
hours in circumference. This was a very dangerous situation and called for a fine microsurgical procedure, lens sparing
vitrectomy.
The decision was not easy, there were several risks: from anesthesia due to low birth weight and prematurity, risk of
cataract, retinal detachment, high refractive error, bleeding, infection, etc. Again, RetCam photographs came to the
rescue, helping the parents to see for themselves the elevation inside the eye (Fig. 2) and understand the gravity of the
situation. A team of skilled professionals interacted with the parents, providing support for the surgery; the team included
a pediatrician, anesthetist, ROP trained retinal surgeon, pediatric nurses and a social worker.
One month after a very challenging surgery, the ROP had completely regressed (Fig. 3). The mother reported that the baby
was looking and smiling back at her! There was joy all around, amongst the ROP team and the parents. The child had
come back from the brink of a lifetime of blindness to enjoy a lifetime of vision. This gift of sight was a team effort in which
correct timing, technology (including infrastructure and facilities), and surgical skills enabled the professionals to handle
a critical situation.
The RetCam and portable diode laser for use in such small babies was facilitated by a generous grant from our
supporters, Sight Savers International, UK.
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