Soon after you welcome a baby into your life, people come pouring in with parenting advice and tips on how to take care of the baby’s health and hygiene.
A newborn baby is delicate with weak immunity, but a preterm baby — one who is born before the 37th week of pregnancy — needs to be given much more care and protection than a full-term baby.
Although preterm babies go through the final developmental stages in the same order as they would in the womb, outside of the womb, they are more susceptible to developing chronic health issues such as asthma and other infections.
Retinopathy of Prematurity (ROP) is one such disease that affects premature babies who weigh about 2¾ pounds or less and are born before 31 weeks of pregnancy. If your baby is born before this time, then it is likely that your doctor may have warned you of this eye disease.
There are five ROP stages during the course of the disease, but most babies do not go through all of the ROP stages. Instead, they become better on their own at the first or second stage of abnormal retinal growth.
The disease progresses from ROP stage I(mild) to ROP stage V(severe). Here’s an account of how this eye condition develops over time.
What happens in Retinopathy of Prematurity(ROP)?
As the name suggests, Retinopathy of Prematurity is a disease of the eye’s retina (‘retino’ meaning retina, and ‘pathy’ meaning disease).
In ROP, abnormal blood vessels start to grow on the surface of the retina – the light-sensitive tissue of the eye – which results in vision problems.
About 14,000–16,000 premature babies born in the US are affected by some degree of ROP.
There are five ROP stages categorized based on severity, ranging from mild (stage I) to severe (stage V).
Although ROP usually gets better by itself as the infant grows up, there’s reason to be concerned if the condition seems to worsen over time.
Why is that?
If left untreated, ROP stages advance quickly and may put your baby at risk of permanent vision loss or sometimes blindness.
The ROP Stages
- ROP Stage I
ROP Stage I is the initial and mildest form of the disease. At this stage, the growth of blood vessels on the retina is only mildly abnormal. Typically, the unwanted growth stops by itself, without the need for special treatment.
There are no indicative symptoms of ROP stage I. Thus, it often goes unnoticed unless an ophthalmologist performs an eye exam. - ROP Stage II
In some babies, the abnormal growth of blood vessels may continue to progress, leading to ROP stage II. While there is moderate abnormal growth on the retina at this point, doctors typically do not recommend surgical ROP treatment options because most babies become better with time and develop normal vision without intervention. - ROP Stage III
When ROP does not resolve by itself on stage II, the abnormal blood vessels begin growing toward the center of the eye rather than on their usual course, i.e., sides of the retina. These fragile blood vessels become engorged and twisted. They leak fluid into the eye, forming scars that pull on the retina and cause retinal detachment.
ROP stage III is critical because treatment at this point may determine the course of the disease. Eye experts recommend laser therapy or eye injections to prevent retinal detachment and vision loss.
You may not notice any visible symptoms of ROP even during stage III. - ROP Stage IV
At stage IV, the retina has already become partially detached. You may notice symptoms such as unusual eye movement, squinted eyes, white pupils (the center part of the eye that is usually black), and vision loss.
At ROP stage IV, it is crucial to seek and continue treatment to protect your child’s vision. If untreated, this condition may worsen to the point of causing legal blindness. - ROP Stage V
Among other symptoms of ROP, a prominent feature that appears at stage V is leukocoria, which literally means ‘white pupil.’ During ROP stage V, abnormal blood vessels continue to rupture, and the resulting scars tug at the retina, threatening to cause complete detachment.ROP stage V requires surgical intervention for treatment and cannot be simply treated with medication. Ophthalmologists usually perform a procedure called Vitrectomy, during which the clear gel fluid (vitreous) present in the eye is replaced with a saline (salt) solution. The surgeon then removes scar tissue, which relaxes the pull on the retina and prevents retinal detachment. A vitrectomy has a 90% success rate. However, some unexplained complications may still lead to lifelong visual impairment in babies.
Risk Factors
There are two major factors that put a child at risk for severe ROP. These include low birth weight and the young gestational age of the baby.
Other factors that also increase the likelihood of ROP include anemia, poor weight gain, poor postnatal development, breathing difficulties, and fluctuations in oxygen inhaled by the baby through breathing air.
If you think your baby may be at risk of ROP or show any symptoms of ROP, consult an ophthalmologist for a detailed eye exam.
Treatment of ROP
If your baby is diagnosed with ROP, the chances are that an ophthalmologist may not suggest any treatment.
Caring for the baby’s overall health often helps improve ROP, and it gets better with time.
However, if your baby is at the advanced stage of ROP (stage III), it could potentially lead to retinal detachment (resulting in permanent vision loss).
Hence, at this point, doctors proceed with either of the two methods of ROP treatment. These are:
- Laser Ablation
- Eye Injections
Laser Ablation, also known as cryotherapy, is a commonly practiced ROP treatment. It is a painless procedure in which a laser beam is directed at the peripheral retina, causing it to burn and scar. This inhibits the growth of abnormal blood vessels and restores vision.
A less common form of ROP treatment is the use of eye injections. In this method, the doctor administers a medicine injection (Avastin or Lucentis) into the eye of the baby, which exterminates the growth of abnormal blood vessels on the retina.
Low Vision Aids for ROP Vision
Unfortunately, despite timely diagnosis and treatment, ROP can worsen and cause severe and permanent vision loss in a newborn as he grows older.
This is why Retinopathy of Prematurity (ROP) is the most common cause of childhood vision loss.
Each year, 400 to 600 babies become legally blind due to ROP.
While there is no cure for permanent vision loss caused by ROP, various FDA-approved low vision aids such as IrisVision Electronic Glasses can help children get the best out of their leftover vision.
Simply put, low vision aids are optical and non-optical devices that are specifically designed to meet the visual needs of people who have mild or severe vision loss.
These devices enhance a person’s leftover vision with the help of assistive features such as high magnification, different contrast settings, brightness levels, and more.
Eye experts may recommend using low vision glasses for your child because vision aids like these can significantly improve a person’s lifestyle. Low vision glasses can help enable your child to carry out daily activities independently, such as making a meal for himself, studying a book, doing homework, watching television, and so on.
