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Understanding Rop

Retinopathy of Prematurity in brief

Early Symptoms

None

Later Symptoms:

white pupils , Unusual eye movements,, vision loss

Diagnosis:

Dilated eye exam by ROP specialist

Treatment:

Observation (for mild cases), laser treatment, eye injections, surgery No oral and topical medicine as of now.

What is retinopathy of prematurity?

Retinopathy of prematurity (ROP) is an eye disease of Retina which occur in babies who are premature (born early) — or who weigh less than 2 kg at birth or has a stormy course after birth needing hospital stay. (Retina is the light-sensitive layer of tissue in the back of our eye.it captures light and send it to the brain for interpretation)
In ROP disease abnormal blood vessels grow in and over the retina . Some babies suffer from mild disease and get better without treatment. But some babies need treatment to protect their vision and prevent blindness.

Is my baby at risk for ROP?

Babies are at risk for ROP if they’re born before 34 weeks of pregnancy or weigh less than about 2 kg at birth.
Older babies with respiratory , cardiac and other issues on discertion of their paediatric doctor
  • This risk increases if they have breathing problems and receive a lot of oxygen therapy.
  • Other medical issues common in premature babies, like heart or lung problems, can also raise the risk of ROP.

What causes ROP?

Normally, a baby’s retinal blood vessels start forming around the fourth month of pregnancy and gets complete by the ninth month. However, if a baby is born prematurely, these vessels may not develop properly. In response, the retina may grow abnormal new blood vessels, known as retinal neovascularization (NV). These abnormal vessels can grow in the wrong direction, and if they extend too far, they can tug the retina away from the back of the eye, leading to a condition called retinal detachment.

What are the stages of ROP?

There are 5 different stages of ROP. These stages indicate the severity of ROP disease.The stages range from stage 1 (mild) to stage 5 (severe):
  • Stages 1 and 2 — Baby in these stages usually get better without treatment and go on to have healthy vision. Doctors need to watch baby carefully and at regular interval to see if their ROP gets reverse or worse.
  • Stage 3 — Some babies who develop stage 3 get better with no treatment and go on to have healthy vision. But others need treatment ( Laser /injection) to stop abnormal blood vessels from damaging the retina and causing retinal detachment (an eye problem that can cause vision loss).
  • Stage 4 — Babies in stage 4 have partially detached retinas and need treatment.This is a serious stage.
  • Stage 5 — In stage 5, the retina detaches completely. Even with treatment, babies in stage 5 may have vision loss or blindness.
Stages 4 and 5 denote critical conditions. babies in these stages frequently need surgery, yet even with treatment, vision loss remains a possibility. Hence, doctors typically start treatment during stage 3. It’s important to note that babies at any stage can deteriorate rapidly and require immediate treatment. So it is very important to adhere to scheduled follow-up checkups of your baby. Early detection and treatment of ROP significantly reduce the risk of serious complications.

What are the symptoms of ROP?

In the early stages of ROP, there are no visible signs like redness, watering, swelling, or white spots in the eye. However, in advanced cases, white spots may appear in the eye due to retinal detachment, where the retina is pulled away from its normal position at the back of the eye. This condition can lead to vision loss and blindness, which unfortunately cannot be reversed. Signs that a baby’s retina might be damaged due to ROP include:
  • Wandering, shaking, or other unusual eye movements
  • Difficulty following objects with their eyes
  • White appearance in their pupils
  • Trouble recognizing faces
Babies who had ROP or were born prematurely are also more likely to develop other eye problems as they get older, including:
  • Myopia (nearsightedness)
  • Strabismus (crossed eyes)
  • Amblyopia (lazy eye)
  • Astigmatism
  • Cataracts
  • Glaucoma
  • Retinal detachment

Action needed by every parent?

If your child had ROP as a baby, it’s really important to take them for regular eye checkups. This helps catch any eye problems early and keeps their vision safe as they grow up.

How will my baby’s doctor check for ROP?

If your baby is at risk for ROP, they’ll need a dilated eye checkup before 1 month of age. During the checkup, some eye drops are instilled in eyes to dilate (widen) the pupil. The doctor will check every part of your baby’s eye for problems — especially the retina. Based on what the doctor sees during this first checkup, they’ll decide if your baby needs further checkups. If they do, the doctor will check their eyes again every 1 to 3 weeks until the retina is fully formed or they’re not worried about the risk of retinal detachment anymore. Frequent eye checkups are crucial because they’re the only way the doctor can catch ROP in its early stages.

What's the treatment for ROP?

Many babies with ROP have mild cases that improve on their own without treatment. However, some babies require treatment to prevent ROP from worsening. It’s crucial to start treatment early to safeguard your child’s vision. Treatment options are:

Laser treatment of retina destroy the abnormal blood vessel growth.

Injection called anti – VEGF drug is administered directly into the eye.it works by blocking the growth of abnormal blood vessels of retina.

Eye surgery. There are 2 types of retina surgery for babies with partially or completely detached retinas (stages 4 or 5):

Scleral buckle surgery

Vitrectomy
The aim of treating ROP is to stop it from getting worse and to prevent blindness. Even if a baby has surgery, they might still lose some vision or become blind. That’s why it’s really important to have regular checkups on time.

Understanding ROP, its
causes and symptoms

Read More
ROP बिमारी में आंसू के पर्दे की खून की नसें या बनती नहीं या खराब तरीके से बनती हैं और आगे चलकर पर्दे को अपनी जगह से हटा सकती हैं जिससे बच्चा अंधा/ नजर कम हो सकती हैं।
आंख का पर्दा आंख के पिछले हिस्से में होता है जो हम बाहर से नहीं देख सकते। (अगर आपने आंख चैक कराई है तो एक दवाई डाली जाती है जिसके बाद धुंधला दिखता है। वो पर्दा चैक करने के लिए होती हैं।) पर्दा बाहर की आकृति/ रोशनी को इकट्ठा करता है और आंख की नस की सहायता से जानकारी मस्तिष्क को पहुंचाता है जिसकी वजह से हम देख पाते हैं
जो बच्चे 34 हफ्ते से पहले पैदा हुए हो/ 2000gm से कम वजन या कोई भी नवजात शिशु जिसे जन्म के बाद इलाज की जरूरत पड़ी हो
हां ROP के जैसी पर्दे की तकलीफ़ अगर पैदा होती है उन्हें NICU में रहना पड़ा हो और stormy course रहा हो 02 खून चढ़ाने इत्यादि।
बाहरी दुनिया मां के गर्भ से बिल्कुल अलग होती हैं। जैसे की O² की मात्रा बच्चे में 30-70 होती हैं और बाहरी दुनिया में जीने के लिए 90-100 होती है पर अगर बच्चे के सारे अंग नहीं बने तो यही O² इसको नुकसान पहुंचातीं है। तेज रोशनी, तापमान जिससे पर्दे के खून की नसों के सामान्य बनना में रुकावट आती हैं।खासकर अगर बच्चे की जान बचाने के लिए इलाज की जरूरत पड़े जैसे की O², खून या ज्यादा दवाई। गर्भ में पर्दा 40 हफ्ते यानी 9महीने के करीब पूरा होता है तो जाहिर सी बात है कि अगर बच्चा पहले पैदा हुआ है तो पर्दा तो नहीं ही बना होगा जिसे अब बिल्कुल ही अलग वातावरण में बनना है जो कि अपने आप में एक बहुत बड़ा चैलेंज है
2 से 3 हफ्ते या पैदा होने के 30 दिन के अंदर
ROP Screening द्वारा
2-3 हफ्ते
इसको आंख के डाक्टर द्वारा जांच कराई जाती है। इसमें आंख की पुतली/तारे को दवाई द्वारा फैलाया जाता है फिर I/O या कैमरे द्वारा पर्दा देखा जाता है। कैमरा द्वारा चित्रें प्रशिक्षित कर्मचारी द्वारा ली जाती है।
तकरीबन 1:30 से 2 घंटे
नहीं केवल D असहज थोड़ी असुविधा, इसलिए बच्चा रोता, इस जांच के दौरान बच्चे के रोने को हम स्वस्थ समझते है। इस नपर को अच्छा मानते हैं।
नहीं, क्योंकि आंख को खोलकर, जांच करने के लिए एक SPECULUM (नेत्र वीक्षक) लगाया जाता है जिसका निशान आंख पर थोड़ी देर रहता है किसी किसी बच्चे में 1आंख लाल रह सकती हैं।
किसी किसी बच्चे में हृदय गति में बदलाव आ सकता है जो अधिकतर स्वत: ही ठीक हो जाती हैं।
पहली जांच के दौरान पता चलता है कि पर्दा कितना बना है उसी के अनुसार 2 से 6-8 बार करवानी पड़ती है।
पर्दे की स्थिति के हिसाब से ये बात डाक्टर तय करता है, 5दिन, 1 हफ्ता, 2 हफ्ता या महिना ये valuable होता है।
नहीं, कोई भी नहीं ना, मां बाप, बच्चे के डाक्टर या अन्य कोई। आंख के डाक्टर भी केवल जब दवाई डालकर पुतली फैलाती है जब पर्दा दिखाई देता है इसमें नाही आंख लाल होती है ना पानी आता है आंख पर सफेदी तब आती है जब पर्दा बिल्कुल खराब हो चुका हो।
“Zero Blindness, Healthy Nation”

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