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Eye Health Center

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Premature Babies and Eye Problems

Caring for a premature baby can be an exhilarating and frightening time for parents. Your newborn has survived despite being born before her time -- a huge relief. Yet you know that, because of her early birth, she has some challenges ahead.

The number of preterm births in the U.S. rose by more than one-third from the 1980s to 2006. While recent rates have declined, this overall increase has health experts concerned. Premature babies have a higher risk for health problems, including certain eye conditions. These include retinopathy of prematurity and strabismus, or misalignment of the eyes.

If you are a parent of a premature baby, you should know the risk for vision problems and what you can do to help prevent vision loss.

Retinopathy of Prematurity (ROP) in Premature Babies

This eye condition tends to occur only in premature babies. It usually affects both eyes and is the leading cause of vision loss in children. Babies who are born weighing about 2¾ pounds at less than 31 weeks are at the highest risk for retinopathy of prematurity. Out of the 28,000 U.S. babies born weighing less than 2¾ pounds, as many as 16,000 will develop some form of ROP. Fortunately, most of these --90% -- have a mild case and won't need treatment. More severe forms of ROP can cause vision loss and even blindness if not treated.

How Retinopathy of Prematurity Develops

In the womb, the eyes start to develop at about 16 weeks. The most rapid growth and development occurs during the last 12 weeks of pregnancy. Experts think that premature birth interrupts this later eye growth, which can lead to ROP. Other risk factors include anemia, breathing problems, blood transfusions, and poor health. ROP causes blood vessels in the eye to grow abnormally and spread throughout the retina. These new blood vessels are fragile and leak blood into the eye. Scar tissue can form and pull the retina away from the back of the eye, causing vision loss.

Eye Exams Detect Retinopathy of Prematurity

The only way to detect ROP is with an eye exam. Parents of all premies should ask their doctor if their child should be tested for ROP. Babies born at 30 weeks and younger, and those who weigh less than 3 pounds should definitely be screened for the condition. If your child does need an exam, the test should be done 4 to 9 weeks after birth, depending on when your baby was born. If the doctor doesn't find any sign of ROP, your baby shouldn't need follow-up exams.

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