Retinopathy of prematurity
Retinopathy of prematurity (ROP) is a retinal disease that occurs exclusively in premature infants. In babies born before term, the development of blood vessels in the eye is not yet complete. In children with ROP, instead of normal development, blood vessels begin to grow abnormally - which can damage the retina and threaten vision.
The disease is time-limited: it will or will not develop within the first 8–10 weeks after birth. Early detection is therefore key.
Who is at risk?
All premature babies are potentially at risk, but the risk is greater the:
earlier the baby is born (especially before 32 weeks of gestation)
lower the birth weight (especially below 1,500 g)
more complicated the postnatal period (need for oxygen, intensive care)
Babies born between 32 and 37 weeks may also develop ROP, but the risk is lower and the disease usually milder.
How does the disease progress?
ROP passes through two phases.
In the first phase, after premature birth, there is a sudden increase in oxygen pressure in the tissues, which interrupts the normal development of the retinal blood vessels - and in some cases, already formed blood vessels may disappear.
In the second, proliferative phase, the eye responds to the lack of oxygen by starting to form new blood vessels - but they grow uncontrollably, in the wrong direction. If not detected in time and treated, they can lead to retinal damage.
How is it detected?
ROP is detected through a special ophthalmological examination (screening) performed every 7–14–21 days, depending on the degree of disease development - until the retinal blood vessels are fully developed. The examination is performed with dilated pupils using specialised equipment for examining premature infants.
How is it treated?
Treatment depends on the stage of the disease. In mild cases, the disease resolves on its own and requires only regular monitoring.
In more advanced stages:
Laser photocoagulation - destroys the peripheral zone of the retina without blood vessels and stops further abnormal growth
Intravitreal anti-VEGF injections - medication blocks the growth of new, abnormal blood vessels
Both approaches aim to stop the progression of the disease and preserve central vision.
What if it is not treated in time?
In severe cases that are not detected or treated in time, ROP can lead to retinal detachment and permanent vision damage or blindness. This is precisely why screening is so important - in the early stages, treatment is effective and outcomes are good.
Children who have had ROP have an increased risk of developing myopia and amblyopia in later years. Regular ophthalmological check-ups are recommended even after the disease has resolved.
Frequently asked questions
Is any special preparation needed for the examination?
Parents arrive with the baby at the clinic 45 minutes before the examination for pupil-dilating drops to be administered. These may be mildly uncomfortable for the baby but do not cause pain.
Does ROP always affect both eyes?
ROP can occur in one or both eyes, and does not have to be equally pronounced in both. Each eye is therefore monitored and examined separately during screening. In some cases one eye may require treatment while the other does not.
Detected in time, ROP is successfully treated.
If your baby was born prematurely, screening examinations are a mandatory and preventive measure for vision preservation.