As medical care is becoming more advanced and sophisticated, more and more premature babies are actually surviving and looking forward to a healthy and normal life. There is, however, one more battle that the tiny “preemies” have to fight. Many of these infants may be affected by a disease called retinopathy of prematurity (RoP), and it is one of the most common causes of blindness in premature babies.
Why are premature babies at risk of going blind?
The eyes begin to grow around 16 weeks and the most rapid growth is in the last trimester of pregnancy. The growth of blood vessels become orderly in the latter stages of pregnancy. If the baby is born before the 31st week, this growth of blood vessels in the retina is disrupted. New abnormal vessels then begin to grow, which are fragile and may bleed or leak fluid. This disease is called RoP.
In more advanced cases, they may get scarred, and pull on the retina, causing retinal detachment. This is why premature babies risk going blind due to retinopathy of prematurity.
What are the risk factors for RoP in premature babies?
Gestational age less than 31 weeks and poor birth weight (especially less than 2.75 pounds) are often the reason for RoP, and why premature babies risk going blind. Other risk factors include anemia, blood transfusions, long stay in the nursery, and poor general health.
How is RoP diagnosed?
Unfortunately, an early diagnosis is key to preserving vision in little babies. The ony way to diagnose RoP is a regular eye examination by a qualified ophthalmologist, who is trained especially to look for the disease. Depending on how premature the baby is, the dilated retinal evaluation will be scheduled four to nine weeks after birth is normal, and then follow-up exams will be scheduled depending on presence of the disease and its severity.
Can blindness in premature babies be prevented?
RoP has five stages, and the treatment for the disease is based on its severity. Despite treatment, most babies still struggle to achieve perfect vision, so prevention of RoP is the best way to prevent blindness.
Treatment for RoPmay include:
Cryotherapy or photocoagulation: The doctor may freeze (cryotheraphy) or seal the abnormal vessels using laser (photocoagulation). This stops the growth of abnormal blood vessels and wards off the subsequent complications like retinal detachment.
Scleral buckling: The doctor may put a band around the eye in order to indent it inwards, which ensures that the retina does not detach from the underlying structures, in order to prevent loss of vision.
Vitreoretinal surgery: This is a complex surgery in which the vitreous or the fluid inside the eye is replaced with another fluid, after removing the scar tissue that is pulling on the retina. This helps in attaching the detached retina again to the back of the eye, as it falls back into place once the traction is removed.
Intravitreal injections: Special medications that decrease the formation of new blood vessels have been used to prevent blindness in adults with age related macular degeration. The same is also being tried in children.
Children who have had ROP, and have been treated for the same are at a higher risk for the following diseases. The complications of RoP which are also reasons why premature babies risk going blind include the following.
Myopia ( or nearsightedness)
Strabismus (squint, or misalignment of the eyes)
Amblyopia (or lazy eye)
Glaucoma
Retinal detachment
It is therefore extremely important that all premature babies be screened for retinopathy of prematurity, since not only is the disease without symptoms in the early stages, even its treatment does not entirely prevent loss of vision. In addition, as the infant battles for life in the nursery, the fact that the eye also need attention is often forgotten, which is why premature
babies often risk going blind.
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