Prematurity can be challenging for children and families alike. Along with conditions that can affect the whole body, the eyes are particularly susceptible to problems immediately after birth and for the rest of your child’s life. Retinopathy of prematurity is a condition that affects premature children, particularly those that are born extremely early and of very low birth weight. In the developing eye, blood vessels start developing in utero. However, if a child is born before that process is complete, there will be a portion of the retina that does not have blood flowing to it. This then starts a process of abnormal blood vessel development that can ultimately lead to a total retinal detachment and lifelong blindness.
Vigilant monitoring is the key to ensuring the optimal outcome for your child. If early signs of retinopathy of prematurity are found, laser treatment can be applied which will slow the process in the vast majority of patients. Surgery can also be performed in severe cases. These have both been proven to decrease your child’s chances of severe vision loss in later life. Your eye care specialist will discuss how often to follow your child to ensure that any early changes of retinopathy of prematurity are found and treated. For low risk infants, following every 2 weeks until 50 weeks of postmenstrual age, or 10 weeks after the original due date, would be recommended. Higher risk infants would need more frequent followup, either weekly or twice weekly.
Your eye care specialist recommends following children born less than 31 weeks of age or less than 1250 grams of birth weight. Other predisposing risk factors include exposure to high levels of oxygen in the neonatal intensive care unit, and certain types of infections. Infants that have multiple medical issues including respiratory distress, bleeding in the brain, or gastrointestinal abnormalities may also be screened more often as directed by the neonatologist.
Once your child has cleared the 50 week postmenstrual date, their risk for retinopathy of prematurity is quite low. However, your child may still be at risk for other eye problems as they get older, including high myopia, or nearsightedness, as well as retinal tears or detachments in later life.
Drs. Melissa Neuwelt and Caesar Luo are both board certified fellowship trained vitreoretinal specialists that have extensive experience with pediatric retina and retinopathy of prematurity. If your child was born prematurely, we would be happy to see your child for a full evaluation.