Dr Dory Neu-Ner

Paediatrics and Retinophathy of Prematurity (ROP)

Dr Dory Neu-Ner   →  Services   →  Paediatrics and Retinophathy of Prematurity (ROP)

Paediatrics and Retinophathy of Prematurity (ROP)

For newborn’s, infants and toddlers, good vision and healthy eyes play a fundamental role in how they learn to see. Just as they are not born talking or walking, their vision develops over a period of time. As a parent, you play a crucial role in assuring your child’s vision and eyes develop the right way.

Parents need to understand if, and when there may be a problem with their child’s vision and immediately discuss it with Dr. Dory Neu-Ner. He is a paediatric eye specialist that treats conditions such as Myopia Progression, Strabismus( Squints) and Retinopathy of Prematurity (ROP).

Why your child might need to visit an ophthalmologist

Eye tests are not only essential for adults, they are extremely important for both children and infants. As a parent, you need to be proactive about your child’s eye development and health. Vision plays a crucial role in the social development of a child. It also contributes to their physical and cognitive development as well as academic performance. To ensure your child’s vision and eye health, make an appointment with Dr. Neu-Ner as soon as possible.

Your child may be experiencing a vision problem if you notice any of the following signs:

  • If they always hold objects close to their eyes
  • They are always squinting
  • They rub their eyes a lot
  • They have poor hand-eye coordination
  • You notice that they are sensitive to light
  • They tilt their head often
  • They show little or no interest in viewing distant objects or even reading

Dr Neu-Ner will conduct a comprehensive vision screening and eye examination that will help protect your child’s sight. If there are any problems, it will be best to pick them up at a young age. Dr. Neu-Ner is an attentive, caring and skilful paediatric ophthalmologist. He looks forward to welcoming you and your child to his practice. Experience professional, efficient and friendly service.

Retinopathy of Prematurity:

The retina is a sheet of nerve cells lining the inner wall of the eye which functions like the film in a camera. Without film, a camera cannot take a picture, and without a functioning retina, the eye cannot see. When a baby is born prematurely, the retina is only partially formed. Blood vessels normally grow on the retina to provide oxygen, starting from the back of the eye at 16 weeks into the pregnancy. The growth is not complete until the end of the pregnancy. In a baby born prematurely, the blood vessels have grown into the retina at the very back of the eye but not into the rest of the retina. When the growth stops, a chemical called VEGF is released that causes abnormal blood vessels to grow, leading to a condition called retinopathy of prematurity or ROP. ROP is a potentially blinding disease that affects several thousand premature babies each year, usually the smallest, youngest, and sickest infants.

Babies at risk include:

  • Born before 32 weeks
  • Birth weight of less than 2kg
  • Prolonged oxygen administration after birth in th Neonatal ICU
  • Poor weight gain in the NICU

Screening examinations for ROP take place from when your baby is 4 weeks old, and start in the NICU. Your Paediatrician will contact the ophthalmologist when your baby is born if it is at risk.

Here’s what to expect when you do a screening exam:

  • An eyelid speculum will be used to keep the eyelids open. This instrument keeps the eye open for longer than usual
  • Your ophthalmologist will use dilating eye drops to enlarge your child’s pupil. This will give your doctor a better view, or bigger window into the eye.
  • The retina will then be checked using a scleral depressor. This instrument is used for controlling eye position. It helps move the eye into different positions allowing your doctor to check the entire retina

Using an indirect ophthalmoscope, your ophthalmologist will then examine the retina. This instrument is worn on the head and sometimes attached to spectacles. It has a special lens that sends a bright light into the eye.

Dr. Dory Neu-Ner is a paediatric eye specialist with the knowledge, expertise and experience to diagnose and treat infants with ROP. He can advise parents on the best course of action for their babies and help prevent the most harmful effects of ROP through careful screening and treatment. He is able to administer all types of treatment for ROP including laser treatment, or injection of durgs to stop the VEGF chemical..

Babies with ROP require lifelong follow up to ensure normal visual development and to prevent any future loss of vision

Have any questions on Retinopathy of Prematurity (ROP) or paediatric eye care? We are here to help. If you do not find your answer below, get in touch with us and we will do our best to provide it.

 

Can retinopathy of prematurity be treated?

Treatment options for retinopathy of prematurity include laser therapy. For infants with advanced ROP, laser treatment may be applied to the peripheral areas of the retina. This intervention can help prevent the progression of ROP and safeguard the child’s vision.

At what stage is ROP treated?

Stage 3: ROP may require treatment to prevent retinal damage or detachment. Stage 4: Severe ROP results in partial retinal detachment and necessitates prompt treatment. Stage 5: Severe ROP leads to complete retinal detachment and demands urgent treatment.

What happens if ROP is not treated?

If severe ROP is left untreated and advances, it can cause the retina to become distorted or detached. These conditions can severely impact vision and may lead to permanent vision loss that cannot be corrected with surgery or corrective lenses.

Can babies with ROP see?

For children with Stage 1 or 2 ROP, the abnormal blood vessels often resolve on their own without causing vision loss. However, your child may have an increased risk of developing eye issues such as nearsightedness later on. Fortunately, many of these conditions can be managed or treated effectively.

At what age should ROP screening be done?

Initial screening for ROP should be conducted at 31 weeks’ postmenstrual age for infants born at 26 6/7 weeks gestation or earlier, and at four weeks’ chronological age for infants born at 27 weeks gestation or later. This screening should be carried out by an ophthalmologist experienced in detecting ROP.

Can ROP go away on its own?

ROP frequently resolves on its own, with only about 10% of infants requiring treatment. However, regular examinations are necessary to monitor for any changes until healing begins. If an eye exam detects more severe ROP, treatment will be required.

Is ROP painful?

Retinopathy of prematurity (ROP) is a condition affecting the retinal blood vessels in preterm infants with low birth weight and is a major cause of childhood blindness. ROP screening involves the use of mydriatic drops and eyelid openers, which can cause pain and discomfort.

How successful is ROP treatment?

While ROP surgery generally has a high success rate, not all infants respond to the treatment. Up to 25% of babies undergoing ROP surgery may still experience partial or total vision loss. Additionally, laser surgery or cryotherapy may sometimes fail to halt the growth of abnormal blood vessels and may need to be repeated.

What are the long-term complications of retinopathy of prematurity?

Late complications of ROP may include myopia, amblyopia, strabismus, nystagmus, cataracts, retinal tears, and retinal detachment.

How fast does retinopathy of prematurity progress?

The risk of rapid progression of ROP is highest between 33 and 36 weeks’ postmenstrual age. However, the potential for progression to a stage requiring treatment can extend up to 43 to 44 weeks’ postmenstrual age, although such progression is uncommon after 41 weeks.

Can retinopathy of prematurity be cured?

Some cases of ROP are mild and resolve on their own. However, more severe cases can lead to scarring that may detach the retina from the eye. These severe cases require surgery to prevent potential vision loss or blindness.

Is ROP inherited?

Studies of twins and siblings have indicated a genetic component to the disease. Research involving monozygotic and dizygotic twins has shown that the heritability of ROP is 0.70 and 0.73, respectively.

Is ROP permanent?

ROP may resolve on its own as the infant develops. However, it is essential for the child to have regular evaluations by an ophthalmologist as they grow. In some cases, timely treatment is crucial to prevent blindness. Without prompt intervention, the child may experience severe, permanent vision loss or even complete blindness.

Is retinopathy of prematurity a disability?

ROP in premature infants can lead to both visual impairment and neurodevelopmental disabilities (NDDs). As a significant cause of long-term visual disability in preterm children, ROP is especially prevalent in resource-limited settings.

Is stage 3 ROP curable?

ROP is classified into stages ranging from 1 to 5, with Stage 5 being the most severe: Stages 1 and 2: Mild to moderate ROP that typically resolves on its own without treatment. Stage 3: ROP that may require treatment to prevent retinal damage or detachment. Stage 4: Severe ROP causing partial retinal detachment, necessitating urgent treatment.