Retinopathy of Prematurity (ROP) is a disease of modern times that affects the youngest and smallest newborn babies.  As our medical science has become more sophisticated in its ability to successfully treat younger and smaller newborns, the disease has appeared with more frequency.  There are many theories as to the cause of ROP but what is known is that once a preterm baby is outside of the uterus, normal everyday environmental factors may have an effect on the developing newborn eye.

The human eye becomes fully developed in utero by about 37 weeks gestational age.  A baby born after 32 weeks gestational age or heavier than 1500 grams is highly unlikely to develop serious ROP.  Babies born before 32 weeks gestational age or smaller than 1500 grams are more likely to develop complications from ROP.  When babies are born preterm their retinas have not fully developed.  Once outside of the safe, secure and controlled environment of the uterus, retinal development will still continue, however, in the presence of normal oxygen and other environmental factors the normal retinal development may be compromised. 

Research has shown that as many as 66% of preterm babies may develop early signs of ROP, however, in 95% of those cases the ROP subsides without treatment and there are no significant consequences.  In a very small percentage of preterm babies their developing retinas may show signs of dangerous ROP.  In these serious cases, the blood vessels that nourish the developing retina may begin to grow out of control and into the center of the eye rather than along the retinal bed.  Without treatment to arrest this uncontrolled growth, the retina may be irreparably damaged.  Careful monitoring of these babies is essential and timely treatment can be highly successful.

Pediatric ophthalmologists regularly monitor those babies at risk for developing serious ROP.  In most instances, the ROP subsides without treatment and the eye proceeds with normal development.  On rare occasions, however, the ROP progresses and may reach the stage known as Threshold ROP.  If the threshold is reached, laser treatment is often offered with very good results at preventing significant visual impairments.

Most serious ROP develops in children whose gestational age is between 32 and 42 weeks.  By 42 weeks it is generally safe to assume the danger has passed, however the period between 32 and 42 weeks is critical and the treatment window may be very narrow. 

Doctors do not cause ROP and even with the best of care the youngest and smallest babies may not respond to ROP treatment.  Sometimes the miracles performed in the NICU may not be enough to prevent complications from ROP but through the skill and diligence of the healthcare team, many severe complications from ROP can be prevented.

*The information above is meant to be a brief overview of Retinopathy of Prematurity from a layperson’s perspective. It is not meant to provide medical advice nor is it meant to present a full medical perspective. Please discuss all your concerns with your pediatric ophthalmologist.