Checking your baby’s eyes for retinopathy of prematurity

This information explains what retinopathy of prematurity is as well as why and how we screen for this.

Why does my baby need an eye check?

The eye check is called a retinopathy of prematurity (ROP) screen. Your baby was born at less than 32 weeks or weighed less than 1.5kg and so they will need an ROP screen. It is important your baby’s eyes are checked because ROP can affect your baby’s sight. If your baby has ROP, they will be monitored regularly and receive treatment if needed.

What is retinopathy of prematurity?

Sometimes when a baby is born at less than 32 weeks or weighs less than 1.5kg the tiny blood vessels in a baby’s retina (the layer in the back of the eye) does not always develop normally. This can lead to the condition known as retinopathy of prematurity (ROP).

There are 5 stages of ROP. Stage 1 is least serious and stage 5 is most serious but is rare. Stage 5 can damage the baby’s vison and will require urgent treatment. About 80 percent of babies born more than 10 weeks early will suffer some degree of stage 1 retinopathy. This usually resolves on its own without any significant effect on their vision.

What causes ROP?

ROP is a condition we see in many babies that have been born prematurely. This is because these babies can be poorly and will also have treatment that make ROP more likely However simply being poorly does not mean a baby will have ROP or that having a healthy premature baby will protect them from having ROP.

Who performs the ROP screening?

A specialist eye doctor (ophthalmologist) will carry out the screening.

When is the ROP screening performed?

The ophthalmologist will carry out the screening (eye examination) initially 4 to 6 weeks after your baby is born when they are at approximately 33 week gestation. The screening will happen when your baby is well enough to have it.

The screen will be repeated every 1 to 2 weeks depending on what the eye doctor finds. It will be repeated until the blood vessels in your baby’s retina are fully grown. This is normally between 38 to 40 weeks (near term).

Where is the screening performed?

Your baby will have their screen on the Neonatal Surgical Unit (NSU) in their own cot.

What happens during the screening?

About 1 hour before the screening your baby’s nurse will put some special eye drops in your baby’s eyes. These eye drops make the pupils (black spot in the middle of the eye) bigger. This helps the doctor see into your baby’s eyes more clearly. Your baby will also have eye drops put in to numb their eyes so they do not feel any discomfort when the doctor uses a special instrument to hold their eyelids open.

The doctor will shine a bright light into your baby’s eyes and will use special lenses to look closely at the back of the eyes to see the condition of the blood vessels on and around the retina.

Will the screening cause my baby pain?

Your baby will not like the examination but will not feel pain. Your baby will feel some pressure and may not like being held still. Sometimes your baby’s nurse may give your baby sucrose (a sweet liquid) to settle them during the examination. Sometimes babies are a little bit unsettled afterwards.

Can I be with my baby during the screening?

Yes you can stay with your baby during the examination. If you prefer not to stay with your baby, that is ok too -some parents or carers do not like to watch. Your baby’s nurse will stay with your baby and help the doctor.

How will I know about the screening?

The nurse and the doctor looking after your baby will explain to you when your baby is having the screening and the outcome. They will keep you informed and answer any questions you may have. Your baby may need regular eye checks even when discharged from ROP screening depending on the stage of the ROP and how premature they were.

Does the ROP tell me my baby can see?

No, it is not a check to tell us if your baby can see. A sight test for this can be done when your baby is older. Premature babies can have an increased risk of developing eye problems as they grow older. Your baby will have regular eye checks if necessary.

Where can I find more information?

The ophthalmic (eye) doctors will be happy to give your more information. The information resource Retinopathy of Prematurity is available which provides more detailed information. You can find further information on the following websites:

www.bliss.org
www.rcopth.ac.uk
www.rnib.org.uk