Retinopathy of prematurity (ROP) is an eye problem that can happen to premature babies. The retina lines the back of the eye. It receives light as it comes through the pupil. From there, the optic nerve sends signals to the brain. ROP is a problem of the blood vessels of the retina. It occurs in stages. It can cause bleeding and scarring throughout the retina. This may cause the retina to detach. A detached retina can cause loss of eyesight.

ROP occurs when the blood vessels in a premature infant's retina fail to develop properly. Babies who are born too early (premature), who are at a lower birth weight, or who are given extra oxygen after birth are more likely to get ROP.

The earlier your baby was born and the smaller your baby was at birth, the higher the risk. Your baby is at the highest risk if they were born at 30 weeks of pregnancy or earlier, or if they weighed 3 pounds, 5 ounces (1,500 grams) or less at birth.

Your baby may still be at risk even if they were bigger or born a little later. This includes babies who weighed between 3 pounds, 5 ounces and 4 pounds, 7 ounces (1,500 to 2,000 grams), or who were born after 30 weeks, if they were very sick as a newborn.

ROP has no signs or symptoms. The only way to find it is through an eye exam by an eye doctor.

An eye doctor (ophthalmologist) will look at your baby's retinas. The doctor should have experience treating ROP. Babies should be screened if they:

• Weigh less than 3 pounds, 5 ounces at birth. They should also be screened if they were born at or before 30 weeks of pregnancy.
• Weigh 3 pounds, 5 ounces to 4 pounds, 7 ounces at birth and have additional risk factors for the condition. They should also be screened if they were born after 30 weeks of pregnancy and have additional risk factors.

Eye doctors use a special system to describe ROP. They use it to figure out treatment and the timing of follow-up exams. When the baby's eyes are checked, the eye doctor describes the stage and zone of the retinopathy. There are three different locations or zones of the retina where retinopathy can occur. There are five different stages of ROP. Eye doctors use these stages to keep track of how serious ROP is. The stages range from stage 1 (mild) to stage 5 (severe).

Your baby will be checked regularly, based on their condition. Many babies need to continue to have eye exams after discharge from the NICU. That is all most babies need. Mild cases of ROP often go away without treatment.

Babies with moderate to severe ROP may need treatment. Treatment usually depends on the severity of the disease. The doctor will talk to you about which treatment is right for your baby. Treatment options include:

• Laser photocoagulation. This uses a beam of light (laser) to treat the outer part of the retina and stop the extra blood vessels from growing. Babies often need general anesthesia for this treatment, so they will be asleep.
• Antivascular endothelial growth factor (anti-VEGF) therapy. The doctor injects anti-VEGF medicine into the inside of the eye (the vitreous), near the retina at the back of the eye. This stops abnormal blood vessels from growing and pulling on the retina. Numbing drops are used, and most babies do not need general anesthesia.

Sometimes ROP pulls the retina out of its normal position in the eye. This is called a retinal detachment. Surgery can be done to try to put the retina back in place. But sometimes there is too much damage for surgery to completely fix it. If this happens, your baby may not see well from that eye.

After treatment, your baby will be checked often. Your baby should have regular exams by an eye doctor. Despite treatment, your baby may still have permanent vision loss.

Preventing premature births is the key to preventing this problem. Finding the condition early and getting treatment can help prevent long-term vision problems.

• ROP is an eye problem that happens to premature babies.
• The earlier babies are born and the lower their birth weights, the greater the risks for the condition.
• Most cases of ROP go away without treatment. When needed, the eye doctor can use a laser to stop the abnormal growth of blood vessels in the eye.
• Ongoing follow-up with an eye doctor is very important.

Tips to help you get the most from a visit to your child's doctor:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions the doctor gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.
• Ask if your child's condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child's doctor after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.