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Retinopathy of Prematurity (ROP)

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What Is ROP?

Retinopathy of prematurity (ROP) indicates a baby was born prematurely before the retinas (light-sensitive nerve tissue lining the back of the eyes) fully matured. The retina contains cells that, when fully formed, convert incoming light into electrical impulses which are carried to the brain and interpreted as visual images. With the incomplete maturation of the retina, a varying degree of partial or abnormal blood vessel growth is present, classified by stages of ROP progressing from one (mild with normally developing vision) to five (detached retina with severe visual impairment or blindness).

How Is ROP Diagnosed?

An ophthalmologist will visit the premature infant in the neonatal intensive care unit (NICU) to survey general eye health and examine the retina for incomplete or abnormal blood vessel growth. If incomplete or abnormal blood vessel growth is detected, the child will be given a diagnosis of ROP.

The child should be monitored routinely by an ophthalmologist because 1) ROP may resolve itself, stabilize, or worsen and require treatment, and 2) ROP increases the risk of strabismus (misaligned eyes), amblyopia (lazy eye), glaucoma (abnormal eye pressure), and blindness caused by retinal detachment.

Are There Treatments for ROP?

Within most of the ROP stages, laser therapy, injections, and surgical treatments are likely to help if diagnosis and treatment occur early.

How Would You Describe the Eyesight of One with ROP and How Will My Child Function with ROP?

While it is possible to have typical vision with ROP, children and adults with ROP commonly experience peripheral field loss (“tunnel vision”) which may progress to global loss of vision as well as myopia (nearsightedness) of the remaining vision.

An individual with loss of peripheral vision has some degree of “tunnel vision” making it difficult to gather comprehensive visual information in an environment; he or she will benefit from learning visual efficiency skills such as scanning an environment in an organized manner. Additionally, the individual is likely to bump into side-lying and low-lying obstacles; he or she should learn orientation and mobility (travel) techniques, such as the use of a cane, to avoid obstacles.

An individual with myopia (nearsightedness) will have blurry distance vision making it difficult, to the degree relative to the severity of myopia, to identify people and facial expressions at a distance, to access information from a classroom board or wall, to view a speaker or performance, to participate in sports requiring the need to respond to moving objects or people, and to remain oriented to the environment when landmarks arenā€™t visible. Additionally, driving will be unsafe if the individual cannot see oncoming traffic or read street signs; the same is true for walking around if the individual isnā€™t proficient in orientation and mobility skills. If even with prescribed corrective lenses, your son or daughter has difficulty accessing visual information at a distance, your child will benefit from orientation and mobility training as well as the use of:

  • environmental adaptations such as high contrast environments, presenting larger objects at a distance, a well-lit room or task, additional time to interpret what is seen, and allowing the child or teen to sit in a preferred seat, nearest the information or activity.
  • distance-vision optical devices such as a monocular telescope and nonoptical devices such as outdoor use of sunglasses and a hat with a brim.

Your child’s teacher of students with visual impairments should perform a functional vision assessment to determine how your child uses his or her vision in everyday life and a learning media assessment to determine which senses your child primarily uses to get information from the environment. These assessments, along with an orientation and mobility assessment conducted by a mobility specialist, will give the team information needed to make specific recommendations for your child to best access learning material and his or her environment.

Resources for Families of Children with ROP