Retinopathy of Prematurity (ROP): What Parents Need to Know 

ROP is an eye condition that affects some premature babies. It happens when blood vessels in the retina (the light-sensitive part at the back of the eye) grow abnormally after early birth.

During the last 12 weeks of pregnancy, a baby’s eyes develop very quickly. When a baby is born early, the blood vessels in the retina may not have finished developing, which can lead to abnormal growth and ROP.

Babies who are born very early, have a low birth weight, or have certain medical complications are at higher risk and receive regular ROP eye exams in the NICU.

ROP exams usually begin 4 to 6 weeks after birth with an ophthalmologist (eye doctor) and continue until the retina is fully developed or no longer at risk.

Your baby’s eyes are dilated with eye drops, and an eye specialist examines the retina using a small instrument. A small device called a speculum may be used to gently hold the eyelids open. This exam can be difficult for families to see and uncomfortable for your baby. Babies need to be held still, and they may cry or become upset during the process. Even when it is brief, it can feel intense. These exams are an important part of protecting your baby’s vision, especially for babies born prematurely.

• Zones describe how far blood vessels have grown across the retina (from zone 1 to zone 3).  • Stages describe how abnormal the blood vessel growth is, ranging from mild (stage 1) to severe (stage 5).

No. Most mild to moderate cases of ROP improve on their own and do not cause lasting vision problems. Your baby’s eye doctor will monitor changes closely.

If treatment is needed, options may include laser therapy, medication (antibody treatment), or, in rare cases, surgery. Your baby’s eye doctor will explain the best option if treatment is required.

Yes. All babies need regular eye check-ups. Premature babies may also be at risk for other vision issues, such as needing glasses or developing crossed eyes, even if ROP improves.

Talk with your baby’s nurse or care team ahead of time about what comfort measures are used before, during, and after the exam.  Depending on your NICU’s policies, supportive options may include:  • Being present and speaking softly to your baby  • Offering gentle touch or hand containment if allowed  • Using sucrose or a pacifier for comfort  • Swaddling or positioning support before and after the exam  • Holding your baby close once the exam is finished  Even seemingly small comfort measures can help babies recover more quickly. If you are unsure what is possible in your NICU, asking in advance can help you feel more prepared.