When Premature Birth Can Result in Eye Problems

Retinopathy of prematurity is an eye problem that happens to premature babies. The good news is that not all babies born prematurely develop the condition and most cases go away without treatment.

However, when retinopathy of prematurity doesn’t resolve on its own, various treatment options are available. Either way, ongoing follow-up with a specialized eye surgeon is very important for your baby.

We asked Faruk H. Orge, MD, Chief of Pediatric Ophthalmology at UH Rainbow Babies & Children’s Hospital, to tell us more and answer some common questions about this condition.

What Causes Retinopathy of Prematurity?

The earlier a baby is born and the lower the birth weight, the greater the risk for the condition.

Retinopathy of prematurity is a problem with the blood vessels of the retina, which lines the back of the eye and transmits information through the optic nerve to the brain. In premature babies, the blood vessels of the retina may not have the chance to develop as they should.

The condition occurs in stages and can cause bleeding and scarring throughout the retina. This may cause the retina to detach. A detached retina, if left untreated, can cause loss of eyesight very rapidly.

How is Retinopathy of Prematurity Diagnosed?

An eye doctor (ophthalmologist) will examine your baby’s retinas if your child is considered high-risk. If the condition is present, the ophthalmologist will identify the stage and zone of the retinopathy to decide treatment and timing of follow-up exams. 

How is Retinopathy of Prematurity Treated?

Your baby will be checked regularly, based on his or her condition.

If your baby needs treatment, the doctor can use a laser or medications to stop the growth of abnormal blood vessels. Although both treatments work, each have advantages and disadvantages. So talk with your doctor about the risks and benefits to both treatments before deciding on a treatment.

If initial treatments fail to stop the condition and the retina begins to separate from the underlying tissue, there are two surgical options for babies with partial or total retinal detachment:

• Scleral buckling – The surgeon places a band around the eye to push a detaching retina back in place.
• Vitrectomy -- The surgeon removes the gel-like substance inside the eye to better reach the back of the eye, then injects a substance to hold the retina in place.

With both surgical options, a laser treatment is applied again.

After treatment, your baby will be checked often. Your baby should have regular exams by a specialized eye surgeon.

Can Retinopathy of Prematurity Be Prevented?

Preventing premature births is the key to preventing this problem. Finding the condition early and getting treatment can help prevent long-term vision problems.

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Newborn surgery is a very specialized form of clinical care. Thanks to highly specialized pediatric neonatal surgeons and state-of-the-art equipment designed just for newborns, University Hospitals Rainbow Babies & Children’s Hospital is expertly staffed and fully equipped to handle any type of newborn surgery. Learn more about pediatric surgery services at UH Rainbow.