Retinopathy of Prematurity

(ROP; Retrolental Fibroplasia; RLF)

Definition

Definition

Retinopathy of prematurity (ROP) is a rare eye condition. It occurs in infants who are premature or have low birthweight. ROP causes a problem in the retina, the tissue that lines the back of the eye.

The blood vessels in the retina grow abnormally.

The abnormal blood vessels can lead to scarring of the retina. In the most serious cases, ROP can lead to a separation of the retina from the back of the eye. In a small number of cases, ROP may cause vision loss or blindness.

Normal Anatomy of the Eye

Copyright © Nucleus Medical Media, Inc.

Causes

Causes

The exact cause of ROP is unknown.

Risk Factors

Risk Factors

Factors that increase the chance of an infant developing ROP include:

  • Premature birth, especially babies born less than 30 weeks gestation
  • Low birth weight, especially babies weighing less than three pounds
  • Low or fluctuating oxygen levels
  • Respiratory distress
  • Anemia

Symptoms

Symptoms

There are usually no signs of ROP until it reaches a severe stage. Severe ROP may cause:

  • White pupils
  • Abnormal eye movements
  • Crossed eyes (turning toward each other)
  • Amblyopia (lazy eye)

Diagnosis

Diagnosis

A specialist will screen for ROP if your infant has risk factors such as prematurity and low birth weight. The doctor will use a special eye exam to view the blood vessels in the retina.

The doctor will examine your infant’s eyes every 1-2 weeks until the blood vessels in the retina are fully developed.

Treatment

Treatment

Mild ROP will usually heal on its own. Your baby’s eye will be examined regularly until the blood vessels heal.

More severe ROP may require treatment to reduce the risk of the retina detaching from the back of the eye. Treatment options include:

  • Cryosurgery—freezing tissue in the eye to prevent the spread of abnormal blood vessels
  • Laser ablation/photocoagulation—a laser stops abnormal blood vessels from growing

Prevention

Prevention

The best way to prevent ROP is to prevent premature birth. Good prenatal care will help decrease the risk of premature birth.

RESOURCES:

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

National Eye Institute http://www.nei.nih.gov

CANADIAN RESOURCES:

Canadian Ophthalmology Society http://www.eyesite.ca

Canadian Pediatric Society http://www.cps.ca/

References:

Fierson WM, American Academy of Pediatrics Section on Ophthalmology, American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus, American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2013;131(1):189-195.

Retinopathy of prematurity. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated April 10, 2015. Accessed June 17, 2015.

Retinopathy of prematurity. National Eye Institute website, Available at:
http://www.nei.nih.gov/health/rop
Accessed June 17, 2015.

Last reviewed June 2015 by Michael Woods, MD
Last Updated: 5/5/2014

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