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Retinopathy of Prematurity

(ROP; Retrolental Fibroplasia; RLF)

Definition

Retinopathy of prematurity (ROP) is a rare eye disorder that happens in infants who are premature or have low birthweight. This problem happens when blood vessels in the tissue (retina) that lines the back of the eye grow abnormally. This can lead to vision problems. Early treatment can improve outcomes.

Normal Anatomy of the Eye

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Causes

ROP happens when blood vessels in the retina do not develop as they should. It is not known why this happens in some infants.

Risk Factors

Things that may raise the risk of this problem are:

  • Premature birth, especially babies born before 28 weeks of pregnancy
  • Low birth weight, especially babies weighing less than three pounds
  • The use of supplemental oxygen, too much oxygen, or changing oxygen levels in the body
  • Low levels of insulin-like growth factor (IGF-1) in the blood
  • High blood glucose
  • Poor nutritional status

Symptoms

There are usually no signs of ROP until it reaches a severe stage. Problems may be:

  • White pupils
  • Abnormal eye movements
  • Eyes that cross and turn toward each other

Diagnosis

An eye exam will be given to infants born prematurely or those with low birth weight. The retinas will be viewed. This is enough to make the diagnosis.

Treatment

Mild ROP will usually heal on its own. An eye doctor will watch for any changes during this time.

The goal of treating severe ROP is to lower the risk of the retina detaching and causing vision loss. Treatment options are:

  • Cryosurgery—freezing tissue in the eye to prevent the spread of abnormal blood vessels
  • Laser ablation/photocoagulation—using a laser to stop abnormal blood vessels from growing

Prevention

The best way to prevent ROP is to lower the risk of premature birth with good prenatal care.

RESOURCES:

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.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:

Retinopathy of prematurity. National Eye Institute website. Available at: http://www.nei.nih.gov/health/rop. Accessed August 31, 2021.

Retinopathy of prematurity (ROP). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/retinopathy-of-prematurity-rop-20. Accessed August 31, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Kari Kuenn, MD  Last Updated: 8/31/2021