Preemies at High Risk for Eye Disorder
Screening Can Prevent Blindness, Experts Say

A potentially blinding eye disorder affecting very premature and low-birthweight babies often can be treated effectively with early diagnosis and intervention, say specialists at Texas Children’s Hospital.

Retinopathy of prematurity, a blood vessel disorder that affects many infants weighing less than 1,500 grams (approximately three pounds, five ounces) or at less than 28 weeks gestational age, can result in severe, irreversible vision problems or even blindness.

“A high proportion of eyes with threshold retinopathy of prematurity – as high as one in four eyes – will have significant visual impairment,” said David Coats, M.D., chief of ophthalmology at Texas Children’s and associate professor of ophthalmology and pediatrics at Baylor College of Medicine. “Early diagnosis and treatment currently are the best lines of defense against retinopathy and are imperative to achieving a good outcome.”

Children born prematurely should be evaluated by an ophthalmologist within four to six weeks of birth, then followed by the ophthalmologist until the risk of developing retinopathy has passed.

Retinopathy attacks the retina and is a leading cause of blindness and visual impairment in babies throughout the United States and the world.

In premature babies, blood vessels behind the eye may not have time to develop, and the vessels often do not develop properly outside the womb. These tiny infants may develop scar tissue, retinal detachment or severe bleeding in the retina – all symptoms of retinopathy.

“Retinopathy can be a devastating result of premature birth,” said James Adams, M.D., medical director of the Texas Children’s Newborn Center and professor of pediatrics at Baylor College of Medicine. “Good diagnostic care in a high-level neonatal nursery, such as the unit at Texas Children’s, identifies at-risk babies, monitors them and provides therapy.”

Texas Children’s ophthalmologists monitor all high-risk infants in the newborn nurseries, screening them for retinopathy until the eye matures.

Retinopathy is treated by lasers or cryotherapy. Both procedures are painless and destroy problem areas in the retina, which causes the abnormal blood vessels to dissolve.

“In most patients where severe retinopathy is diagnosed and treated, we achieve good – but not perfect – vision,” Coats said. “Affected infants must be followed during the first months and years of life, because all severely premature infants risk developing other problems, such as eye misalignment, lazy eye or the need for thick, corrective glasses."

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©2006 Texas Medical Center

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