What is retinopathy of prematurity? | Symptoms, causes & treatment

Retinopathy of Prematurity (ROP) is an ocular disease that largely affects preterm babies, particularly those born before 31 weeks of pregnancy or weighing less than 2.75 pounds at birth. The disease is characterized by a disorderly growth of retinal blood vessels that could lead to irregular scarring or retinal detachment, potentially causing severe visual impairment or even permanent blindness. 

ROP usually manifests itself in both eyes. While not all infants with the disease will experience devastating visual losses, a small percentage often deal with severe damage requiring immediate medical intervention. It is therefore imperative that these infants receive regular, ongoing examinations from an eye specialist.

ROP typically exhibits no physical signs, and the affected infants typically do not show any symptoms. This makes the disease challenging to detect in its early stages without conducting thorough eye tests. Regular screening of preterm babies is therefore critical for detecting ROP before it can result in significant vision loss. 

The primary cause of ROP is abnormal retinal blood vessel development. Normally, the eye's blood vessels start to develop around the 16th week of pregnancy, growing from the optic nerve at the back of the eye towards the front. By the time of normal term birth, these blood vessels are fully formed. In preterm infants however, this process might be disrupted, leading to abnormal vessel growth after birth when exposed to differing oxygen levels than what would normally be experienced in-utero. Other causes may include overall poor health of a preterm infant or slow weight gain post-birth.

ROP often resolves on its own without causing any lasting eye or vision defects. However, in more severe cases, different treatments are available and are usually most effective when implemented early. 

Laser therapy or cryotherapy is commonly used to stop the growth of abnormal blood vessels by destroying the peripheral parts of the retina. This is done to prioritize blood flow to the more crucial central area of the retina. Another relatively new treatment involves injecting a drug into the eyes to halt abnormal vessel growth, a method that has been quite effective in certain patients. In instances where the retina has begun to detach, surgical interventions such as scleral buckle or vitrectomy are employed. 

Post-treatment follow-ups are crucial as the retinal detachment may reoccur, or other conditions like glaucoma and strabismus may develop. Moreover, children who had ROP are generally more susceptible to certain eye problems such as nearsightedness, crossed eyes, lazy eye, and glaucoma, later in life, emphasizing the importance of regular eye check-ups all through childhood and later years. 

Above all, the most efficient approach towards ROP is preventive care – ensuring that preterm infants receive appropriate oxygen levels, maintaining a healthy weight gain, and conducting regular screening tests for early detection. 

In summary, Retinopathy of Prematurity is an avoidable health problem resulting primarily from premature birth, which can cause severe visual impairment if not diagnosed early and treated promptly. It is therefore critical for health practitioners to be diligent in monitoring preterm infants to ensure the best possible outcome for these vulnerable patients.