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A premature child may suffer from a variety of health issues. Some health conditions recover quickly and certain health issues can cause permanent damage. Therefore, premature babies need better care and attention than normal babies.
Retinopathy of Prematurity is a serious health condition in premature babies. It can cause permanent blindness in the child if not treated properly. Therefore, you should know everything about this health condition to prevent it.
What Is Retinopathy of Prematurity?
Being a severe eye condition, the retinopathy of prematurity can cause permanent blindness in premature babies. The blood vessels in a premature baby’s retina can grow abnormally and cause blindness.
We can see objects because the retina (the inner layer of the eye) turns the received light into visual signals. These signals are sent to our brain and then processed so that we can see. The retina blood vessels in a premature baby can grow oddly.
This condition can cause significant damage to the retina. Not every premature baby experiences this issue, but the child can get blind if the condition is severe. The ROP in the worst-case scenario can force the retina to detach from the inner layer of the eye. Consequently, the child can get blind.
Premature babies, who are born before 31 weeks and weigh less than 1250 grams, can suffer from retinopathy of prematurity. Therefore, they require special care to recover faster.
What Are the Causes of Retinopathy of Prematurity?
The pregnancy period is quite critical for the proper growth of a child. The blood vessels start developing from the center of the retina when the mother is 16 weeks pregnant. These blood vessels ramify outward to spread across the edge of the baby’s retina.
It happens during the first eight months of pregnancy. The baby develops completely in this period and gets healthier.
The growth of blood vessel can get disrupted in premature babies. Premature birth can lead to abnormal growth of blood vessels in the retina. It can cause bleeding eyes and blindness! A highly skilled ophthalmologist can perform certain eye tests to diagnose the disease and treat it quickly.
The main causes of ROP recognized by doctors are as follows:
Premature birth
Premature babies have extremely low body weight. Therefore, they are kept under observation for several days. Immature retina and underdeveloped blood vessels in the retina can lead to ROP. Just like other body parts, eyes also develop completely during 8 months of pregnancy.
Premature babies are born in 7 months or earlier. Their body parts, including the eyes, are underdeveloped. Therefore, the risks of Retinopathy of Prematurity increase. A premature baby can also suffer from more serious diseases if not examined quickly after birth.
Oxygen therapy
The doctors believe two types of therapies can lead to ROP in a newborn baby.
Prolonged treatment in the incubator
If the oxygen therapy lasts much longer, oxygen concentration levels will be quite high. There will be much high arterial partial pressure of oxygen. It can increase the risks of Retinopathy of Prematurity. Patients kept in the incubator for a long time can develop the signs of ROP. Therefore, doctors should constantly examine the baby.
A sudden drop in oxygen concentration
If the oxygen concentration suddenly stops, the tissues can get hypoxic. It can cause deformities of blood vessels in the eyes and lead to ROP. Although this disease has nothing to do with the shortage of oxygen, sudden oxygen concentration changes can cause this issue.
Other notable causes of ROP
Beta-blockers: The use of this type of medicines during pregnancy can be harmful to the child. It can enter into the fetus through the placenta and enhance choroidal vascular tone. Consequently, the risks of ROP development can increase.
pCO2: If the partial pressure of carbon dioxide in arteries gets too low, it can cause retinal vasoconstriction, ischemia, and ROP!
Maternal anemia: Multiple fetuses and maternal anemia are also responsible for ROP in some newborn babies.
The risks of ROP also increase in case of acidosis, hypoxia, anemia, hyperbilirubinemia, blood transfusion, hypoglycemia, hypernatremia, patent ductus arteriosus, etc. Eye professionals still can’t pinpoint a particular issue responsible for cause ROP.
Premature birth increases the risks of this problem, but not all premature babies suffer from ROP. Therefore, it is tough to accuse a specific thing of causing ROP.
What Are the Symptoms of Retinopathy of Prematurity?
The initial development of ROP takes deep inside the eyes. Therefore, it is quite tough to tell the initial symptoms of this disease. It won’t be possible to tell whether the newborn baby is suffering from ROP by looking into his eyes.
An ophthalmologist, who is well-trained in recognizing eye-related health issues, can diagnose this disease early. Professionals know how to screen a newborn child’s eyes for ROP. He knows how to examine the retina for abnormal blood vessel growth.
The American Academy of Pediatrics has outlined a screening method to diagnose ROP symptoms. All the intensive care units in the USA have professionals to look for Retinopathy of Prematurity symptoms.
Some infants can develop visible symptoms of ROP, which are as follows:
Abnormal eye movement or nystagmus
White pupils or leukocoria
These two symptoms indicate the baby has some sort of eye-related health issue. Parents should contact a well-known ophthalmologist for further screening to diagnose the real health issue. The eye specialist can provide a proper cure in the early stage of disease and save your child’s eyesight.
How to Treat Retinopathy of Prematurity?
This disease gets worse in different stage. There is no treatment required in the first stage. You might spot some lesions in the second stage, but regular observation is enough to deal with it. The doctor will suggest immediate treatment if the disease is in the third stage.
The doctor can choose the following treatments to cure Retinopathy of Prematurity:
Surgical Treatment
1. Cold treatment
This treatment has helped 50% of patients in preventing the development of macular folds, posterior lens fibrosis, and retinal detachment. The doctor will apply cold treatment to the avascular area surrounding the retina.
This treatment involves the use of local anesthesia. It is not completely safe though! It can cause hemorrhage, bulbar conjunctival edema, vitreous hemorrhage, retinal hemorrhage, and central retina artery occlusion.
The doctor can choose another treatment as a long-term cure to prevent complications!
2. Laser photocoagulation treatment
This treatment has shown better results in recent years. It is probably the best treatment for ROP in stage I and II.
This treatment reduces the risks of postoperative bulbar conjunctival edema, vitreous hemorrhage, and intraocular inflammation. Doctors in many countries suggest diode laser treatment to cure Retinopathy of Prematurity.
The infrared light or red light from the diode laser penetrates effectively. The risks of complications are pretty low and recovery chances are quite high.
3. Scleral cerclage
If the disease progresses uncontrollably and reaches stage IV or V, Scleral cerclage is the treatment to trust. The doctor will be able to reattach the retina and preventing blindness. A few researchers still believe that the baby can heal without surgery.
4. Vitrectomy
It is possible to cure children with failed sclera cerclage with vitrectomy treatment. It is a complicated surgical treatment. There are 40% chances to reattach the detached retina and save the baby’s eyesight. The child will have limited eyesight and the doctor won’t promise full recovery!
Medical treatment
1. Oxygen therapy
Oxygen therapy can be necessary to save a premature baby’s life. It was not allowed to provide oxygen to premature babies in the past, but now it is considered a reliable solution. Recent studies show that hypoxia can increase the risks of Retinopathy of Prematurity. Therefore, doctors now trust oxygen therapy to prevent the development of ROP in premature babies.
2. Neovascularization inhibitor
This treatment is still not approved for the treatment of ROP. However, it shows promising results. It can soon become a go-to choice as a Retinopathy of Prematurity treatment.
What Can You Do to Prevent Retinopathy of Prematurity?
Many health experts around the world prohibit the use of oxygen for newborn babies. It should be provided only in critical conditions.
Oxygen’s concentration should not be above 40% if it is a life-threatening situation. The healthcare provider should not give oxygen to a newborn baby for prolonged periods.
The doctor should avoid applying large doses of vitamins as a treatment. It can prevent the risks of ROP and keep the child healthy. Doctors should call an eye specialist for a perfect examination of the baby’s eyes. The eye specialist can diagnose ROP in its initial stage and treat it before it gets worse.
Conclusion
Retinopathy of Prematurity is a rarely known eye condition for many parents. Many doctors in developing or underdeveloped nations do not know anything about this disease. It can cause blindness if not diagnosed quickly.
This disease does not show any sign or symptoms in the early stages. Only proper screening allows the ophthalmologist to diagnose the issue and treat it quickly. Therefore, physical examination of a newborn baby or premature baby is important to prevent such issues.
