Retinopathy of Prematurity (ROP)
Premature babies are at risk for aquiring a disease of the developing eye called retinopathy of prematurity (ROP; formerly called retrolental fibroplasia). ROP can occur in babies who are born at less than 32 weeks of pregnancy, but the highest rate occurs in babies who are born at less than 28 weeks.
Premature babies are at risk for ROP because the retina (the membrane at the back of the eye that helps transform light into images) is less developed and only partially covered with blood vessels at birth. Many premature babies get supplemental oxygen soon after birth. High levels of oxygen, or fluctuation in a baby's oxygen level, can damage the partially formed blood vessels of the retina. (There have, however, been cases of ROP in babies who have never received extra oxygen.)
When ROP develops, the blood vessels in the baby's retina begin to grow irregularly and may bleed and form scar tissue. In the most severe cases, scar tissue can pull on the retina and cause it to detach from the eye, resulting in blindness. Ten to thirty percent of premature babies may get ROP; however, only a few cases result in impaired vision or blindness.
To prevent ROP, extremely premature babies should have their blood oxygen levels closely monitored. Babies who are born prematurely should have their eyes examined by a pediatric ophthalmologist at four to six weeks of age, and then every two weeks until the blood vessels in the retina are completely grown. If a baby has signs of severe ROP, frequent eye exams and special therapy (for example, laser surgery) may be necessary to treat the irregular growth and prevent ROP from progressing.
Other Eye Problems
Other common eye problems for premature babies include nearsightedness (myopia) and lazy eye (strabismus). A baby with strabismus may need to wear an eye patch or have surgery. Former premature infants should continue to have their vision checked yearly by an eye doctor, even after their ROP has gone away.
Premature babies are at increased risk for hearing abnormalities and should have their hearing tested before discharge from the hospital. If the tests are abnormal, the baby should see a specialist for further evaluation and treatment.