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Screening Preemies For Retinopathy Of Prematurity

Screening Preemies For Retinopathy Of Prematurity

You know that babies are born after nine months of their mothers housing them in their womb, keeping them safe and healthy in there. However, not every baby remains inside the mother for full term – or 40 weeks. Some babies are born much earlier and babies born before the 37th week of gestation are known as premature babies.

Now, here’s the thing with preemies. Because they’re born earlier, a lot of their organs might not be fully developed. Inside the mother’s womb is an environment that’s conducive – dark, quiet and with the right amount of nutrition being provided. Once the baby is born, the light, the noises around and the chances of an infection increase, making the development process a bit more challenging.

While a preterm birth brings in complications for the mother also, yet, the biggest difference is the fact that the mother can communicate about her problems well, while her baby can’t.

Treatment to some of these conditions premature babies develops involve keeping them away from their mothers in incubators, with tubes, injections and all those scary equipment that look extremely painful.

While infections and minor common diseases can be dealt with, babies who weigh below one and a quarter kg are at a very high risk of being affected by this particular disorder called Retinopathy of prematurity (ROP).

Understanding Retinopathy of Prematurity

ROP primarily affects babies that are born before 31 weeks of gestation (A full-term has a gestation of 38–42 weeks). This disorder usually develops in both the eyes and is one of the most common causes of visual loss in childhood that can lead to lifelong vision impairment and blindness.

Retinopathy Of Prematurity

This condition makes blood vessels grow abnormally and randomly in the eye. These vessels tend to bleed, scarring the retina which is the layer of nerve tissue in the eye that helps us see.

There are five stages of retinopathy of prematurity ranging from mild (stage I) to severe (stage V):

  • Stage I —The growth of the blood vessel is mildly abnormal.
  • Stage II — The growth of the blood vessel in stage two is moderately abnormal.
  • Stage III — The abnormal blood vessels grow toward the center of the eye instead of following their normal growth pattern along the surface of the retina.
  • Stage IV —  The retina is partially detached in this condition from the scar produced by bleeding, abnormal vessels pull the retina away from the wall of the eye.
  • Stage V — The retina is completely detached in the V stage of the disease. The baby can have severe visual impairment and even blindness if left untreated at this stage.

Stages of Retinopathy Of Prematurity

Most preemies improve with no treatment and eventually develop normal vision in stage I and II. Even in stage III, it’s only after a certain degree that the condition is thought to be very serious.  Treatment should be considered when infants have a certain degree of Stage III, IV and V and develop ‘Plus Disease’ (blood vessels of the retina enlarged and twisted) indicating worsening of the disease. At this point, treatment has a good chance of preventing retinal detachment.

What Next?

Your child’s vision is precious as you would want them to recognise you, read, write and just have a normal life. Therefore, if a child has issues with vision, it’s something that needs to be taken seriously. Unlike adults and older children, babies can’t really explain whether they are able to see or not, which is why, diagnostic screening tests are necessary to take the right steps, medically.

What gets parents really panicky is the procedure of screening and treatment. It is nerve-wracking for them to imagine their baby go through all the trauma and pain. We, at Ankura ensure sensitivity and intensive care for the babies. We work towards making the treatment as comfortable and painless as possible.

It is recommended that all preterm babies with a birth weight of less than 1,500 grams or a gestational age of 30 weeks or less should be screened by an ophthalmologist. Depending on how premature the baby is, the first screening should occur four to nine weeks after birth.

If the examination result says that the retina is fully ‘vascularized’ (blood vessels have finished growing normally), no follow-up is needed.  However, If there are signs of ROP, Our ophthalmologist will set follow-up exams to monitor the condition and determine when treatment is needed.

Here’s what’s typically involved in the screening of the eye:

  • Dilating eye drops to enlarge the pupil, making room for the doctor to get a better view of the condition of the eye.
  • An eyelid speculum which holds the eyelids open is placed.
  • A scleral depressor is used that helps move the eye into different positions so the entire retina can be checked.
  • An indirect ophthalmoscope which has a special lens that sends a bright light into the eye is used to enable the doctor to examine the retina.

A special camera, RetCam is being increasingly used by doctors which make examination easier by taking high-resolution digital pictures of the retina. This provides detailed images from one exam to the next to help compare and track the health of your child’s eyes over time.

It is very important for the equipment to be highly sterilized and germ-free for the child to be protected from any infection caused by the equipment. All body parts are very important but eyes are one of the most important parts of the body that, if damaged, can hamper daily living severely, hence, the life of the child must be in able hands to ensure complete recovery.

We at Ankura provide you with the best ophthalmologists who are gentle and careful with babies and sterilized, cutting edge equipment to ensure healthy recovery. For us at Ankura, quality treatment comes before anything else. Our doctors are extremely sensitive to the child’s medical needs.

About the Hospital:

Ankura Women and Children’s Hospital has been treating eye disorders since our inception in the year 2011. Ankura Hospitals is a chain of super-specialty hospitals for women and children in the cyber city of Hyderabad. Set up in the year 2011 in KPHB, near Hitech Railway Station, the Ankura Hospitals family has today spread its wings to Secunderabad, Khammam and Vijayawada.