Prematurity and visual impairment

How does prematurity affect my child’s vision?

Both our eyes and brain are responsible for helping us to see.

Our eyes collect pieces of visual information from our surroundings and our brain puts them together to form an image, a bit like putting pieces of a jigsaw together.

Babies who are born extremely prematurely or a very low birth weight are more likely to have vision problems than babies born at full term or a normal birth weight. This is because their eyes or brain may not be fully developed when they are born.

Babies born very prematurely will have their eyes examined by a specialist eye doctor and it is recommended that they have their eyes checked regularly as they grow.

Babies born prematurely are more likely to develop a need for glasses, a squint or a lazy eye than babies born at full term.

There are also some conditions affecting the eyesight that premature babies can be born with:

• Retinopathy of prematurity
• Periventricular Leukomalacia

What is retinopathy of prematurity?

The retina is a layer at the back of the eye containing light sensitive cells.

In premature babies, the blood vessels taking oxygen to the retina are not fully developed. This means some of the cells in the retina do not get enough oxygen. This can cause scar tissue to form and can cause the retina to pull away from the back of the eye and detach.

What is the treatment for retinopathy of prematurity?

The blood vessels within the retina will continue to grow for the first few weeks of your baby’s life. For most babies, the retina and the blood vessels fully develop on their own and no treatment is needed.

If the retina is severely affected or does not get better on its own, the Ophthalmologist can do a laser procedure which aims to strengthen the vessels in the retina. This would be done when your baby is asleep and is not painful. Your doctor will tell you more about this treatment if it is needed.

What is periventricular leukomalacia?

The brain of a premature baby can suffer damage from a lack of oxygen. This is because the normal blood supply has not yet grown to reach all parts of a premature baby’s brain.

‘Periventricular leukomalacia’ means how a premature baby’s brain looks on a scan when it has suffered damage from a lack of oxygen. It means ‘soft white areas around the ventricles’. Ventricles are spaces within the brain which are filled with fluid.

The tissues near the ventricles help carry visual information from the eyes to the brain. Damage in this area can stop the visual information from reaching the brain. This can lead to cerebral visual impairment (CVI). Cerebral visual impairment is where the eyes themselves may be normal, but there is a problem with how the brain process visual information.

What support is available?

If your baby’s vision is affected by their prematurity, we can offer advice and refer you to specialist vision support clinics. We can also refer you to education support services and direct you to relevant support groups.