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Eye Exam for Retinopathy of Prematurity

by Alexandra Howson, PhD

Definition

During this exam, an eye doctor (ophthalmologist) examines the interior of the eyes through a special lens. The doctor checks for any damaged blood vessels in the retina. The retina is a light-sensitive layer of tissue on the back of the inside of the eye.

Normal Anatomy of the Eye

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

Retinopathy of prematurity (ROP) is a rare condition that occurs in the eyes of infants who:

  • Are born prematurely
  • Are born with a low birth weight

With this condition, the blood vessels of the retina grow abnormally. This can lead to bleeding and scarring in the retina. ROP usually heals by itself. Most infants do not require treatment. In a small number of cases, ROP may cause vision loss or blindness. This exam is done to determine if the infant has ROP and, if so, what type of treatment would be the best option.

Possible Complications    TOP

Your infant may need eye drops during the exam. Your doctor will discuss the complications that may be caused by eye drops, such as:

  • Stinging or discomfort in the eye
  • Light sensitivity
  • Blurred vision
  • Lid swelling
  • Red eyes

Be sure to discuss these risks with the doctor before the eye exam.

What to Expect    TOP

Prior to Procedure

  • Do not feed your infant right before the exam.
  • If recommended by the doctor, give your infant a pacifier during the exam. This may help to soothe her.
  • The doctor will put eye drops in your infant’s eyes. These will dilate the pupils (the dark area in the center of the eye). The drops will take about 30-60 minutes to work.

Anesthesia

The doctor may place drops in your infant’s eyes to numb them and keep her comfortable.

Description of the Procedure

After your infant is born, eye exams are usually scheduled to take place in 4-6 weeks. The eye exam will be done in the doctor’s office.

An assistant may gently place your infant in a blanket and hold her during the exam. The doctor will use an eyelid speculum to keep your infant's eyelids open. A special lens will be used to send a bright light into the eye. The doctor will check your infant’s retina. An eyelid depressor will also be used. This tool will help the doctor to move the eye in different directions.

How Long Will It Take?

30-60 minutes

Will It Hurt?

The dilating eye drops can cause stinging. The exam can cause discomfort, as well. Ask the doctor if your infant will need medicine to keep her comfortable.

Post-procedure Care

At the Care Center

Right after the exam, the doctor will tell you about the condition of your infant’s eyes. Follow up will be scheduled if your child needs a procedure or repeat screening.

At Home

Depending on the strength of the eye drops, your infant’s eyes may be dilated for 4-24 hours.

Call Your Doctor    TOP

After arriving home, contact the doctor if any of the following occurs in your infant:

  • Discharge from the eye
  • Redness or swelling
  • Loss of vision or other eyesight changes
  • Signs of infection, including fever and chills
  • Nausea or vomiting
  • Shortness of breath or trouble breathing
  • Any new symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Academy of Pediatrics
http://www.aap.org/
National Eye Institute
http://www.nei.nih.gov

CANADIAN RESOURCES:

Canadian Ophthalmology Society
http://www.eyesite.ca
Canadian Pediatric Society
http://www.cps.ca/

References:

DynaMed Editorial Team. Retinopathy of prematurity. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 5, 2010. Accessed April 26, 2010.
Lewis R. Retinopathy of prematurity. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/default.php?id=3 . Published November 11, 2008. Updated date. Accessed April 15, 2010.
National Eye Institute. Retinopathy of prematurity. National Eye Institute website. Available at: http://www.nei.nih.gov/health/rop . Updated February 2010. Accessed April 26, 2010.
Olitsky SE, Hug D, Smith LP. Retinopathy of prematurity. In: Kleigman RM, Behrman RE, Jenson HB, Stanton BF. Nelson’s Textbook of Pediatrics . 18th ed. St. Louis, MO: Saunders; 2007.
Samra HA, McGrath JM. Pain management during retinopathy of prematurity eye examinations: a systematic review. Adv Neonatal Care . 2009;9;3:99-110.
Last reviewed June 2012 by Kari Kassir, MD
Last Updated: 06/04/2012