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Vision and Hearing

Why It’s Important to Perform Eye Exams for Premature Infants

Premature infants are at greater risk than full-term infants for eye problems. These include amblyopia, known as lazy eye; strabismus, a misalignment of the eyes; glaucoma, increased pressure within the eye; an early need for glasses; and severe visual impairment. A long-term follow up is needed with an ophthalmologist, an eye physician, to help identify these potential eye problems that may develop.

What is retinopathy of prematurity

Retinopathy of prematurity, known as ROP, is a potentially blinding disease caused by abnormal development of retinal blood vessels in premature infants. The retina is the inner layer of the back of the eye. In premature infants, the retinal blood vessels are underdeveloped. Usually, the infant would still be in the mother’s womb when the eyes finish developing. Because the child is not in the womb, the growing environment is different, and the retinal blood vessels may grow abnormally.

A treatable condition

Approximately 3.9 million infants are born in the U.S. each year. About 14,000 are affected by ROP, and 90 percent of those affected have a mild case that resolves on its own. About 1,100-1,500 develop the disease severe enough to require medical treatment. Despite available treatment, 400-600 infants each year in the U.S. become legally blind from ROP. 

Note, not all infants born prematurely are at risk for ROP. Those at the highest risk for ROP are born before 31 weeks gestation or weigh 1250 grams (just under 3 pounds) or less. A nurse or doctor in the neonatal intensive care unit usually identifies infants at risk for ROP. If a baby is at risk for ROP, an ophthalmologist will perform several eye exams at repeated intervals to screen for ROP until the retinal blood vessels have finished growing or the child is no longer at risk for ROP. 

Most infants who develop ROP will only develop a mild form of the disease that will improve on its own and will develop normal vision. Some infants will develop a severe form of ROP that can lead to a retinal detachment, which is when the retina becomes pulled away or separated from the eyewall. This can lead to permanent blindness.

The good news is that there are treatments for ROP. If ROP becomes severe, treatment will be recommended to occur in a timely fashion to reduce the chance that the eye will develop a retinal detachment and permanent blindness. The goal of regularly scheduled screening and treatment is to avoid retinal detachment and protect infants from permanent visual loss.

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