RETINOPATHY OF PREMATURITY
FAILING TO PERFORM AN EYE EXAMINATION
BEFORE 6 WEEKS IN A PREMATURE INFANT
CAN LEAD TO BLINDNESS FROM RETINOPATHY OF PREMATURITY (ROP)
Babies that are born premature and with a low birth weight require that an eye examination be performed by an Ophthalmologist (eye doctor) between 4 and 6 weeks after birth for the purpose of examining the eyes to determine of the child is suffering from Retinopathy of Prematurity (ROP). ROP also used to be called retrolental fibroplasia. ROP is a condition of the retina that occurs in low birth weight premature infants that can lead to blindness. If an examination is performed by an Ophthalmologist on a timely basis, surgery can be performed by a trained Ophthalmologist to prevent the condition from progressing to the point where it causes retinal detachment that would lead to blindness, which can often be permanent.
At the present time, Neonatologists in every neonatal intensive care until (NICU) in the United States adheres to this practice as a standard of care for avoiding blindness in premature infants. In addition, many NICUs have some sort of reminder system in place to make certain that the eye examination is, in fact, performed before 6 weeks are up so that the baby does not slip through he cracks. Included in that reminder system is some method by which they keep track of babies that were discharged from the hospital before six weeks of age without an eye examination to make sure that the parents get the baby to an out-patient examination with an Ophthalmologist. This is because the consequence of failing to get the timely eye examination in a premature baby that turns out to have ROP may have a terrible consequence of life long blindness, which could often be avoided if the eye examination is performed on a timely basis and proper follow-up care continues from there.
Unfortunately, there are many hospitals that have no system in place to make sure that the eye examination get performed before 6 weeks. Even thought the Neonatologists and Pediatricians in those hospitals have every intention of making sure that each baby gets an eye examination, the lack of a system for making certain that the eye examination occurs results in babies slipping thought the cracks. Some of those babies end up blind. Even worse is that in these hospitals, babies slip through the cracks on a regular basis, resulting in multiple blind children.
Our office has had the experience of several hospitals across the country that were not using some method of making sure that the eye examination was performed before six weeks on premature babies where multiple premature babies ended up blind as a result.
What types of methods are effective to make certain that the eye examination gets performed? Different hospitals use different methods, but it can be as simple as having a binder with loose leaf paper with a list of every premature baby in the NICU, the deadline for the eye examination, and a space to check off when that eye examination is completed. Other hospitals put a colored sticker on each baby’s incubator to indicate that the eye examination has not yet been performed. When the eye examination is completed, the sticker is changed to a difference color. These are not expensive or burdensome procedures. The binder with the loose leaf would cost less than $10.00.
The loss of even one child’s vision is priceless.
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