At Eyes to See, we treat a variety of eye conditions in children. One of these conditions is ROP or Retinopathy of Prematurity. It's estimated that around 14,000 premature babies are born with ROP each year in the United States. Of these, many can recover on their own and others recuperate under the careful supervision of an eye doctor, potentially requiring treatment. With ROP being a fairly common condition, we want to help parents whose child may have been diagnosed with it to better understand what's happening in their child’s eye. Read on to learn more about Retinopathy of Prematurity, how it’s treated and diagnosed, and its potential symptoms and complications.
What is ROP?
ROP, which stands for Retinopathy of Prematurity, is a disease of the eye. It can affect babies who are born prematurely, weigh less than 3 pounds when they’re born, have breathing problems, or have experienced other medical problems common to premature infants.
ROP is caused by abnormal growth of blood vessels in the retina (the layer of tissue that detects and processes light in the back of the eye). In mild cases of ROP, babies may recover without treatment. However, others will require treatment to prevent blindness and safeguard their vision.
The Stages of ROP
ROP has been categorized into 5 stages, with stage 1 being moderate and stage 5 being severe.
Babies with stages 1 or 2 ROP may be able to recover without treatment. Doctors will closely observe them for a period of time to ensure that the ROP does not worsen or cause other issues.
Babies with stage 3 ROP may also get better without treatment. Others, however, may require treatment to prevent abnormal blood vessels from harming the retina or causing retinal detachment (which can lead to partial vision loss or blindness).
Babies who have stage 4 ROP will require treatment because, at this stage, their retina has begun to detach itself from the blood vessels around it. This is called partial retinal detachment, and it can cause partial vision loss or lead to blindness if left untreated.
Babies with stage 5 ROP have experienced complete retinal detachment. At this stage, treatment can help, but babies may still have vision loss or blindness.
Due to the degenerative nature of ROP, it must be diagnosed and treated as early on as possible. If found and treated early, there is a much lower chance of ROP having serious, long-term effects on a child’s vision.
Additionally, ROP can progress rapidly from any stage, so your baby must get their follow-up examinations on schedule.
A Deeper Look at What Causes ROP
As previously stated, ROP is caused by the abnormal growth of blood vessels in the retina. Usually, the blood vessels in the retina begin development four months into pregnancy and finish developing around the estimated time of birth in the ninth month of pregnancy.
However, if a baby is born prematurely these blood vessels may begin to develop abnormally which is called retinal neovascularization (NV for short). In this process, the blood vessels may grow in the wrong direction and, being attached to the retina, pull the retina off the back of the eye, causing retinal detachment.
Risks and Complications
As mentioned above, the most prominent complication that babies with ROP are at risk for is retinal detachment, which can lead to blindness. Retinal detachment is when the retina (the thin layer of tissue at the back of the eye that detects and processes light) pulls away from the surrounding blood vessels. These blood vessels provide oxygen and essential nutrients to the retina, but in the event of retinal detachment, they are no longer able to do so. This causes vision loss.
Additionally, children who had ROP as babies are at risk of developing other conditions of the eye as they get older, so it’s imperative that they visit the eye doctor regularly. A few conditions that those who’ve previously had ROP may develop later in life are amblyopia (lazy eye), myopia (nearsightedness), crossed eyes, and retinal detachment.
The Symptoms of ROP
ROP doesn’t have any symptoms until it reaches the advanced stages. If a baby has acquired eye damage due to a severe case of ROP, a few symptoms you may eventually notice are:
Their eyes shake or otherwise move unusually
Their eyes wander or don’t follow objects
Their pupils appear to be white
They struggle with facial-recognition
How do Doctors Detect ROP?
Since there aren’t symptoms early on, you may be wondering how doctors can detect ROP early enough to prevent it from damaging the eyes. If your baby is at risk for ROP, your doctor will tell you that they need a dilated eye exam. In most cases, this is done within 1-2 months after the baby is born.
At the exam, the eye doctor will use dilating eye drops to widen your baby’s pupils, which allows them a good view of each part of their eyes. Based on what the doctor determines at the first exam, you may need to schedule a follow-up appointment. If your baby has ROP or the eye doctor is concerned that they may develop it, they will check your child’s eyes every 1-3 weeks until there are no concerns about retinal detachment.
How is ROP Treated?
As stated previously, babies with mild cases of ROP may recover without treatment. But if a case of ROP requires treatment, it can be treated in a variety of ways depending on what method the eye doctor determines will be most effective in protecting the baby’s vision.
One way ROP can be treated is through the use of laser therapy on the sides of the retina. This helps to protect the eyesight of the child and may prevent the ROP from worsening.
ROP may also be treated using injections that go into the eye and block the growth of blood vessels. These are called anti-VEGF drugs.
Babies with stage 4 or 5 ROP may be treated using retinal surgery. There are two kinds of surgery and these are done only on babies who are experiencing partial or complete retinal detachment.
One such method of surgery is called a vitrectomy. The eye doctor performs a vitrectomy by making small openings in the eye wall and replacing much of the vitreous (a gel-like fluid inside the eye) with a saline solution. Afterward, the doctor will remove scar tissue from the retina. Laser treatment may also be utilized to further treat the retina and ensure it stays in the proper position
Another type of surgery used to treat retinal detachment in cases of ROP is called scleral buckle surgery. In this procedure, the doctor puts a flexible band around the sclera (the white part of the eye) to support the detached retina until the eye begins to grow normally. The band is removed once the eye has grown normally.
All of these treatments can be used to protect the eye from further damage and, in some cases, prevent vision loss. If your child requires treatment, their eye doctor will decide which method of treatment will be most effective based on the unique needs of your child.
Summary
In summary, Retinopathy of Prematurity is a common condition that generally affects babies who were born early. It is caused by abnormal blood vessel growth in the retina. ROP possesses varying degrees of severity and may or may not require treatment depending on the case. In severe cases, ROP can cause partial or complete retinal detachment which can lead to blindness or partial loss of eyesight. Children who’ve had ROP as babies are at risk for developing other eye issues later in life. ROP doesn’t have symptoms unless it is in its late stages, so doctors cannot rely on them to diagnose, but will instead need to perform a dilated eye exam. If a baby needs treatment for ROP, there are several options including laser therapy, injections, and two types of surgery. In mild cases, the eye doctor may choose not to pursue treatment and allow the eye to heal on its own under careful observation.
We hope that you found this post informative and can move forward with confidence and understanding if your child has (or is suspected to have) Retinopathy of Prematurity.
We understand that it can be frightening to hear that there may be issues with your child’s eyes, and we want to help. If you’ve been told that your child needs an eye exam but aren’t sure where to start, give us a call at 616-796-9995, and we’ll gladly help you to schedule an appointment with us.
Comments