Retinopathy of Prematurity (ROP) is a leading cause of preventable childhood blindness, particularly in developing nations where NICUs are expanding.
It is difficult to imagine a mother’s fear for her premature infant, born two months early and weighing only 3-5 pounds. Without access to a Neonatal Intensive Care Unit (NICU), the infant’s survival is uncertain. While the increased availability of NICUs is improving the survival rates of preterm infants, inadequate screening and treatment programs for ROP have led to a rising incidence of ROP-related blindness.
ROP is an eye disease affecting premature infants caused by abnormal growth of blood vessels in the retina. If left untreated, it can lead to retinal detachment and permanent blindness. Each year, millions of babies are born preterm and require neonatal intensive care. Many of these infants need oxygen therapy, which, if not properly regulated, increases the risk of ROP. Unfortunately, only a fraction of babies in developing nations are screened for ROP, leading to missed diagnoses. As a result, thousands of children suffer vision loss or complete blindness from this preventable condition.
Preventing ROP blindness requires coordinated efforts among NICU pediatric staff, ophthalmologists, and neonatologists. Every NICU must have the necessary equipment and guidelines for oxygen management, coordinated screening, and treatment options such as laser therapy or anti-VEGF injections. Advances in technology, including telemedicine and artificial intelligence-aided screening retina cameras, improve the effectiveness and efficiency of early detection and intervention.
Scaling up ROP management and treatment services is essential for preventing childhood blindness. Identifying NICUs needing equipment, training, and supplies will ensure every infant can be screened and treated.
“For many families, a child blinded by ROP faces a lifetime of challenges. This is preventable if we can build the capacity of every NICU in every country. The burden of care starting in infancy can be overwhelming for poor families.” John Barrows, President & CEO. International Eye Foundation.
The International Eye Foundation (IEF) understands the critical importance of preventing vision loss and blindness in infants. Beginning in early 2000, IEF supported pioneering ROP screening in Asia, Latin America, and the Caribbean with grants and technical support.
ROP affects premature infants placed in incubators to support their underdeveloped lungs. If oxygen levels are not carefully regulated, abnormal blood vessel growth in the retina can lead to irreversible blindness. While mild ROP requires ongoing observation, moderate to severe cases must be treated by laser therapy or antiVEGF drugs to prevent retinal detachment. The increasing availability of NICUs and incubators in low- and middle-income countries (LMICs) has inadvertently heightened the risk of ROP. Many NICU staff lack adequate training in oxygen management, and pediatric retinologists are scarce.
Emerging research using artificial intelligence shows promise in addressing this gap. AI-driven equipment and software can analyze images taken by trained technicians, determining whether an infant requires specialist referral or continued observation. ROP initiatives must prioritize timely screening, early intervention, and comprehensive care, particularly in NICUs. By strengthening healthcare infrastructure and leveraging technological advancements, we can make significant strides in preventing blindness among premature infants. Safeguarding the sight of newborns ensures a lifetime without disability.