Retinopathy of Prematurity Retinopathy of Prematurity |
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Eye Clinic & Optometry Centre for Children and Adults

Retinopathy of Prematurity


Retinopathy of prematurity (ROP) is a disease that results from abnormal growth of blood vessels on the retina in a small percentage of premature babies.

In ROP, the retina is not fully vascularised and the retina is ischaemic (insufficient blood). The ischaemic retina produces angiogenic factors which causes uncontrolled growth of blood vessels (neovascularisation). This causes fibrovascular scar formation. When the scar matures, it will contract and result in tractional retinal detachment.

Not all premature babies will develop ROP. In some cases, the abnormal blood vessels may shrink and go away without treatment.


Who are at risk of ROP?

  • Low birth weight
  • Prematurity (e.g. a 12-week premature baby has higher risk of ROP than 8-week premature  baby)
  • Use of supplemental oxygen after birth
  • Complicated postnatal course
  • Respiratory complication
  • Anaemia
  • Race (Caucasians are more at risk than African-Americans)


How is ROP detected?

An ophthalmologist (eye doctor) can examine baby’s eyes for ROP in hospital’s NICU (neonatal intensive care unit) or in the clinic. Eye drops to dilate the eyes (to enlarge the pupils) will be given prior to examination. A speculum (to hold open the eye) and an indenter (to help the doctor to examine the peripheral retina) are used during the examination. To minimize any discomfort, anaesthetic eye drop will be instilled.

Some ROP will only be apparent after 4-6 weeks following birth. If ROP is diagnosed, regular examinations will be performed until the abnormal vessels growth goes away on its own, failing which treatment will be offered.

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Instruments and eyedrops used for examination of ROP


  • No treatment
    No treatment is needed for early stages of ROP.
  • Laser for ROP
    In advanced ROP, laser treatment is often used to destroy the abnormal vessels on the retina.It usually causes less inflammation and collateral damage than cryotherapy. It is less painful. There is less myopia and visual results are better.


    ROP laser can be done under local anaesthesia (LA) or general anaesthesia (GA). GA is more commonly chosen as there is no pain for the baby. Even under LA, the pain is still quite substantial. Duration of laser is around 1 hour.

  • Cryotherapy
    Cryotherapy uses a special instrument to freeze and destroy the abnormal vessels.


Follow Up

As premature babies are more likely to develop visual problems such as high refractive error, squint, amblyopia etc., they should be followed up regularly for vision test.