World Health Organization (WHO) celebrates the World Expo Day every year on November 17, to put the headlamp on premature…
Retinopathy of Prematurality (ROP) is a dynamic, time-bound disease that is not present at birth. The condition is associated with the eyesight of children who have previously received intensive newborn care (with or without oxygen treatment) that help save their lives but seriously affect their eye development.
The condition is characterized by the development of abnormal blood vessels in the retina, resulting in scarring and retinal removal. ROP can be mild and can resolve spontaneously, but in serious cases it can progress and lead to blindness.
ROP usually only starts two weeks after birth, which provides a window for screening and activation of treatment at the right time, while the child is still undergoing newborn care at the hospital.
However, ROP can be treated by lasers if detected by proper retinal examination before 30 days after birth. “Tees Din Roshni Ke” (thirty days for Vision) should be a slogan implemented for all early children. Inability to get the first retinal screening done efficiently and on time is a big gap that needs to be addressed. Lack of trained staff to deliver effective treatment at bed for children, especially those who are still in critical care, and then the difficulties with a follow-up are some of the gaps that need to be addressed.
Chronic hypoxia (lack of oxygen), intrauterine growth retardation and prenatal and postnatal conditions are the most common triggers of ROP. Children born for 34 weeks gestation and weighing less than 2000 grams are especially susceptible to ROP and must be screened within 20-30 days of birth.
High levels of extra oxygen and high carbon levels are also known to aggravate ROP. During neonatal incubation, premature babies should be mixed with oxygen, strictly controlled and monitored by pulse oximeters. Other risk factors associated with the condition include anemia, bradycardia (low heart rate), blood transfusions and intraventricular haemorrhage (hemorrhage).
The initial incubators for pre-terms were established in Boston in 1
941 and first ROP blind children were immediately reported in medical journals in 1942. Since then, there has been a great deal of research and understanding of risk factors and successful management of this condition. Today, we have extensive knowledge to prevent ROP blindness and have successfully done it for more than 90 percent of the children. While many children now receive ROP screening on time and are treated in many large and smaller cities in India, there are major gaps and therefore there are still many ROP blind and visual victims of premature children.
A very tight safety net has to be introduced to keep the premature child with the potential good vision they are born with. Gaps in this aspect can lead to irreversible injuries and a lifetime for poor vision.
Common gaps include the absence of information about ROP among various cadres of healthcare professionals and parents during the first critical days; The medical curriculum for only a few super specialists including ROP; and lack of trained staff to deliver effective treatment for children who are still in crisis management, among other things.
All early people run a higher risk of developing other eye and vision related complications later in life. Common disorders include retinal detachment, myopia (myopia), strabismus (crossed eyes), amblyopia (lazy eye) and glaucoma.
ROP is a potentially avoidable cause of irreversible and usually total blindness in children prematurely. This disease has lifelong consequences for affected children and their families. Survival is achieved because of the great efforts of parents, extended family, doctors, nurses and health policy makers, in addition to technological progress and after the well-worked processes under critical care of the newborn child.
WHO has highlighted ROP as an important target disease in its prevention of blindness programs, “Vision 2020: Right to Sight”, to combat global unrestrained blindness by 2020. On this world’s prematurity day, everyone involved should not only think about “newborn survival” but also their “vision”.
(Dr. Subhadra Jalali, Director, Newborn Eye Health Alliance, LV Prasad Eye Institute Network, Hyderabad. The views are personal. She can be reached at [email protected])  – IANS
Jalali / vm
! (This story has not been edited by Business Standard staff and is automatically generated from a syndicated feed.)