Retinopathy Of Prematurity (ROP)

Retinopathy of prematurity (ROP) is a disease of the developing retinal blood vessels in babies born very early or very small. The vessels, which normally finish growing around full term, stop and then grow abnormally; in severe cases scar tissue pulls the retina off, causing lifelong blindness.

Most ROP is mild and resolves without treatment. A minority progresses within a narrow window of weeks, and timely laser or injection treatment prevents blindness in most of those babies. Everything depends on screening at the right time in the neonatal unit.

Symptoms

• No outward signs that parents can see in the early, treatable stages
• Disease is detected only by screening examinations of the retina
• Late signs of untreated disease: a white pupil, roving eye movements, not fixing on faces
• Later childhood effects: high short-sightedness, squint, lazy eye

Causes and risk factors

Risk rises the earlier and smaller a baby is born, particularly under 31 to 32 weeks of gestation or under about 1500 g, with local criteria varying by country. Fluctuating or high oxygen levels, infection, poor weight gain and general illness add to the risk. In the first phase, vessel growth stalls after birth. In the second, the under-supplied retina releases growth signals such as VEGF that drive abnormal vessels at the boundary of vascular and avascular retina.

How it is diagnosed

• Screening by indirect ophthalmoscopy: An ophthalmologist examines the dilated retina, starting around 4 to 6 weeks after birth or 30 to 31 weeks postmenstrual age, and repeats every 1 to 2 weeks until the vessels mature.
• Wide-field retinal imaging: Digital photographs that document disease and support remote review.
• Classification by zone, stage and plus disease: Determines whether to observe or treat, following international criteria.

Treatment options

• Observation: Most babies need only repeat examinations until the retina is fully vascularised.
• Laser photocoagulation: Treats the avascular outer retina. Established, durable, usually within 48 to 72 hours of reaching treatment threshold.
• Anti-VEGF injection: Used particularly for posterior disease. Works fast but ROP can recur weeks to months later, so prolonged follow-up is mandatory; long-term systemic safety is still being studied.
• Vitrectomy or scleral buckle: For retinal detachment. Visual results are limited.
• Long-term follow-up: Glasses, squint and amblyopia care through childhood for all babies who had significant ROP.

When it is urgent

ROP treatment is time-critical: once a baby reaches treatment criteria, it should be given within about 2 to 3 days. If your baby is in a neonatal unit and screening has not been mentioned, ask the team. In an older child with a history of ROP, new flashes, floaters, a shadow or a drop in vision needs same-day local eye care, because late retinal detachment can occur.

Travelling to Türkiye for treatment

Acute ROP cannot be managed by medical travel. The babies concerned are fragile inpatients, the treatment window is a matter of days, and screening must happen in the neonatal unit caring for them. Please do not plan to fly a premature baby abroad for it. What a visit can offer is for older children and adults with a history of ROP: a detailed paediatric eye assessment, a second opinion on the late effects such as high myopia, squint, cataract or retinal traction, and planned surgery for those problems.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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