Premature Babies and Eye Problems
Retinopathy of Prematurity (ROP) in Premature Babies continued...
Treatment may include:
Cryotherapy (freezing) or photocoagulation (laser therapy) to stop blood vessels from growing and keep the retina from pulling away from the back of the eye.
Scleral buckling, where a band is placed around the eye. This pushes the eye inward, which helps keep the retina in place against the walls of the eye. The band will be removed in a few months or years.
Vitrectomy is a more involved surgery. The vitreous fluid inside the eye is replaced by a saline solution, and scar tissue is removed from inside the eye. This allows the retina to relax in place against the eye wall.
Treatment can help preserve central vision, which allows us to see straight ahead, read, see colors, and drive. Some side vision may be lost as a result of these surgeries.
Potential Complications of Retinopathy of Prematurity
Children who have had ROP have a higher risk of developing certain eye conditions, such as:
- Myopia (nearsightedness)
- Strabismus (misalignment of the eyes)
- Amblyopia (lazy eye)
- Retinal detachment
Regular eye exams as recommended by an eye specialist are especially important for children who had ROP. If caught early on, most of these conditions can be treated without any vision loss.
Strabismus in Babies
About 4% of children in the U.S have strabismus. Infantile esotropia is a type of strabismus that occurs in premature babies. When the muscles that surround and control the eye don't work together, it causes the eyes to point in different directions. Strabismus is thought to occur in premies because the baby's brain hasn't developed enough to control the eye muscles. Other factors related to strabismus in babies include:
- Brain or nerve disorders, including water on the brain, bleeding in the brain, seizure disorders, cerebral palsy, and other conditions
- Retinal damage from ROP
- A buildup of blood vessels under the skin (hemangioma) near the eye
- Brain or eye tumors
- A cataract or eye injury
- Developmental delay
Children with any of these conditions should be examined by a pediatric eye care specialist. Also contact the doctor if you notice that your child's eyes are crossing.
Complications of Strabismus
Because the eyes focus in two different areas, the brain receives two different images. To compensate, the brain ignores the image from the crossed eye and perceives the image from the straighter eye. This can affect depth perception.
Strabismus can also lead to amblyopia, or lazy eye. This occurs when the crossed eye doesn't develop good vision and may even lose vision. About one-third of children with strabismus develop amblyopia.
If the child has developed amblyopia, this will need to be treated first. The stronger eye will be covered with a patch so that the brain only sees images from the weaker eye. This strengthens the crossed eye and improves vision. Children may not like wearing an eye patch, but it is important to follow through on treatment. Amblyopia can become permanent if treatment is delayed.