Retinopathy of prematurity

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Retrolental fibroplasia; ROP

There are 5 stages of ROP.

• Stage I: There is mildly abnormal blood vessel growth.
• Stage II: Blood vessel growth is moderately abnormal.
• Stage III: Blood vessel growth is severely abnormal.
• Stage IV: Blood vessel growth is severely abnormal and there is a partially detached retina.
• Stage V: There is a total retinal detachment.

The blood vessel changes cannot be seen with the naked eye. An eye exam is needed to reveal such problems.

An infant with ROP may be classified as having “plus disease” if the dilation and twisting of the blood vessels matches or exceeds a standard photograph.

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Symptoms of severe ROP include:

• Abnormal eye movements
• Crossed eyes
• Severe nearsightedness
• White-looking pupils (leukocoria)

High-risk infants and those younger than 30 weeks gestation or born weighing fewer than 3 lbs should have retinal exams.

The first exam usually should be 4 - 9 weeks after birth, depending on the baby’s gestational age. Babies born at 27 weeks or later usually have their exam at 4 weeks of age. Those born earlier usually have exams later.

Follow-up examinations are determined based on the results of the first exam. Babies do not need another examination if the blood vessels in both retinas have completed normal development.

Parents should know what follow-up eye exams are needed before the baby leaves the nursery.

Review Date: 05/04/2011
Reviewed By: Daniel E. Bustos, MD, MS, Private Practice specializing in Comprehensive Ophthalmology in Eugene, OR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).