Retinopathy of Prematurity (ROP) is a serious eye condition that affects premature babies. It happens because the blood vessels of the retina — the light-sensitive layer at the back of the eye — are not fully developed at birth. Babies born before 34 weeks of pregnancy or weighing less than 2 kilograms are at a higher risk of developing this condition.
ROP is especially dangerous because it is a silent disease. There are no visible signs, no redness, no watering, and no obvious symptoms in the early stages. Parents may feel that the baby’s eyes look completely normal. However, if left undetected and untreated, ROP can progress rapidly and lead to irreversible blindness. This blindness is permanent and can affect the child for life, impacting education, independence, and overall quality of life.
The reassuring news is that ROP-related blindness is largely preventable. If the condition is detected early and treated at the right time, we can save the baby’s vision. This is why the timely screening of premature babies is extremely important.
Across the world, standard medical guidelines recommend that all premature babies undergo an eye examination starting at 3 to 4 weeks after birth. Screening does not stop after one visit. These babies require regular follow-ups until the retinal blood vessels have fully developed and the risk period has passed. Missing screening or non-compliance with advised follow-ups can be risky, as ROP can develop even after a few weeks if the retina is immature and can worsen, leading to retinal detachment, causing potential blindness if left untreated.
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The screening process itself is simple, quick, and safe. Special eye drops, designed specifically for premature babies, are used to dilate the pupils. After dilation, a retina specialist examines the baby’s eyes. The procedure is done under topical anaesthesia, which makes it painless. Small, blunt, sterile instruments are used carefully to keep the eyelids open and help in examining the retina. These instruments are safe and do not harm the baby’s eyes. The entire examination takes only a few minutes.
If ROP is detected at a stage where treatment is required, timely intervention with laser therapy or injections can prevent progression to blindness and completely halt the disease pathology. The key is early detection.
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In present times, where advances in neonatal care have improved the survival of premature babies, awareness about ROP screening must increase at the same pace. Many parents are still unaware that their premature baby needs a mandatory eye check within the first month of life.
Parents must understand that they should not wait for any symptoms to appear. By the time signs or symptoms appear, such as the eyes begin appearing smaller, a white reflex is noted, or the child does not follow light, it may already be too late. Early screening is not optional; it is essential and very important.
A simple eye examination at the right time can protect a child from lifelong blindness. Raising awareness about ROP screening is the need of the hour, and every premature baby deserves the chance to see the world clearly.
Dr Prabhjot Kaur is a Senior Consultant Ophthalmologist at Dr Agarwals Eye Hospital, New Delhi.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.