Retinopathy of Prematurity (ROP) is a potentially blinding disease of the eyes that affects infants either born preterm, underweight, or admitted to the neonatal intensive care units (NICU). The good thing about ROP is that the child is not born with the disease, and it can be prevented. The child is healthy at birth and the ROP occurs 2-3 weeks after birth so there is a window of opportunity (initial 20-30 days) when a trained ROP doctor (an Eye Doctor) can diagnose ROP in a newborn and start the needed treatment. Hence the slogan 'Tees Din Roshni Ke'/ 'Thirty Days to Vision'.
There is an urgent need to create awareness about ROP among parents, caregivers, and healthcare practitioners.
'Retinopathy of Prematurity (ROP) is the leading cause of irreversible vision loss in preterm babies or babies born with a birth weight less than 2.0 kgs. The efforts by Ministries of Health over the last two decades to reduce neonatal mortality have improved the survival of preterm babies. But this has also led to an increase in the number of babies at risk of blindness due to ROP. About 30% of the children in NICUs are expected to be affected by ROP and close to 10% of them can go completely blind if they don’t receive timely treatment within 30 days of birth.
ROP is symptomless and does not cause any pain, redness, or watering in the initial stage. It is externally visible at 3 or 4 months of age, but by then the child would have already lost their vision. Only a trained ophthalmologist, by performing a detailed retinal examination using eye drops can diagnose ROP. Hence, all preterm or underweight babies must undergo a detailed eye examination within 30 days of birth. There is a 50% or greater risk of vision loss if left untreated after this. If treated on time, the child can have reasonably good vision and can lead a better quality of life,' says Dr David Aggarwal, Vitreo-retina Consultant, Kode Venkatadri Chowdary Campus, Vijayawada, L V Prasad Eye Institute.
L V Prasad Eye Institute’s Kode Venkatadri Chowdary Campus at Vijayawada has a state-of-the-art advanced retina facility managed by a team of experienced and specialized doctors offering comprehensive and holistic care for the management of Retinopathy of Prematurity. The team is also actively working in collaboration with city-based paediatric hospitals and NICUs for ROP screening in newborns. To date, over 6370 babies have been screened for ROP at LVPEI’s Vijayawada campus. Of these, 2270 were diagnosed with ROP and provided the needed treatment. Over 3500 babies have been screened till date at the city based NICUs and of these close to 900 babies were identified and treated for ROP.
Do all babies need a retinal examination for ROP?
Babies with a birth weight lower than 2 kgs or those born at less than 34 weeks of pregnancy are most likely to have ROP. Any other preterm baby who has had problems after birth (lack of oxygen/ infection/ blood transfusion/ breathing trouble, etc.) is also vulnerable.
Why does it occur?
The inside of the eye (the retina) is not fully developed in a premature baby due to early birth. Abnormal blood vessels can develop in such a retina; this can cause bleeding inside the eye and even progress to retinal detachment. This is called Retinopathy of Prematurity (ROP). The result is irreversible low vision or blindness.
What is the treatment for ROP?
ROP is treated with laser rays or Anti-VEGF injections (depending on the stage of ROP). The treatment helps to stop the further growth of abnormal vessels thus preventing vision loss. In advanced-stage ROP, vitreoretinal surgery and rehabilitation is the only choice.
What is the role of society in preventing ROP?
- Role of parents: To be vigilant about this disease and to bring their premature/underweight newborns for a retinal eye examination without fail within 30 days of birth.
- Role of Paediatricians: Their prime role is to detect at-risk babies for ROP and refer them to a trained ROP eye doctor for retinal examination.
- Role of ophthalmologists (Trained retina specialists): To train other eye doctors for ROP screening, so that referral for further management can be made in time.