Pediatric Ophthalmology Consultants

About Premature Baby Eyes

The physicians who are taking care of your baby have asked an ophthalmologist to examine your child’s eyes. This examination is especially important because your child was born prematurely and may have special eye problems that need careful attention.

The Eye

When a baby is growing inside its mother, it is in a protected environment. The baby develops slowly until he or she is able to continue growing outside the mother.

The retina is the inner lining of the back wall of the eyeball. The retina is the part of the eye that receives sight through the pupil and sends it to the brain. (You might think f the eye as a camera: the retina is the film.) The retina receives blood through blood vessels. These blood vessels are the last part of the eye to develop just before a full-term baby is born. So when a baby is born early (prematurely), the retinas of that baby’s eyes are not fully developed.

What is Retinopathy of Prematurity?

Retinopathy of Prematurity is the name of a disease that frequently affects the eyes of very small premature babies. Physicians are still not sure of all the reasons why, but the blood vessels in the retinas of some premature babies do not develop in the way they should. This abnormal blood vessel growth is called Retinopathy of Prematurity (or “ROP” for short). In spite of the best care hospitals can give, ROP still develops in certain infants. We have noticed that ROP is more likely in very smallest babies who have the most complications. Signs are usually apparent while they are still in the Newborn Intensive Care Unit. ROP can cause blindness, but not for most babies. If ROP does develop, one of three different things can happen:

  1. In the majority of premature babies with ROP, the blood vessels that did not grow correctly heal competently before the baby is one year old.
  2. In some infants, the blood vessels that did not grow correctly leave scarring in the retina when they heal. These babies may have to wear glasses because they are nearsighted (myopic). They may also develop lazy eye (amblyopia) or a wandering eye (strabismus). Medical care can usually correct these problems if the child is seen by an eye physician at an early age. It is important that an ophthalmologist continue to examine your baby’s eyes regularly, to be sure that your child reaches school age with the best possible vision.
    Sometimes, the partially healed ROP leaves worse scarring in the retina that might cause eye problems that cannot be fixed by glasses or even by surgery. To control the damage as much as possible, these children need medical eye care regularly for the rest of their life.

When scarring in the eye from ROP is the worst, the blood vessels in the retina keep on growing incorrectly and form into a large amount of scar tissue, which can shrink and pull the retina loose from the inside of the eye. This is called retinal detachment. Retinal detachment usually means that the baby will not be able to see well or it might even mean that the baby will become blind. Fortunately, this happens only to a very small number of eyes with ROP (about 5%).

The doctors who are taking care of your baby are watching carefully for any signs of Retinopathy of Prematurity. This may mean that your baby will need eye examinations for the next few weeks or months. If your baby’s eyes are developing the more severe kind of ROP, the doctors will talk with you about surgery to help protect your baby’s vision.

American Academy of Ophthalmology The Eye M.D Association


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