What is ROP? ROP stands for “retinopathy ofprematurity”. It is a proliferative retinal vasculopathy that occurs in premature and low birth weight infants and can progress to retinal detachment, leading to vision loss. This disease has become the first childhood blindness in developed countries and the leading childhood blindness in our country. Do all premature babies have ROP? The answer is no. ROP usually occurs only in preterm infants born at less than 32 weeks of gestation and with a birth weight of less than 2,000g. The smaller the weight and the smaller the gestational week, the higher the incidence of ROP and the more severe the condition. Is ROP caused by oxygen inhalation? The main reason for the development of ROP is that the gestational week and weight at birth are so small that the child is immature and the retinal vessels become diseased during the maturation process. However, prolonged high concentration of oxygen after birth is also a major risk factor for the development of ROP. At present, there are guidelines for the use of oxygen in the treatment of preterm infants in China, and all neonatal intensive care units in major hospitals strictly follow the guidelines for oxygen administration, so the incidence of ROP is decreasing year by year, but because of the improvement of neonatal monitoring technology, the number of viable preterm infants increases year by year, so the total number of ROP is increasing. How to detect ROP? Early detection of ROP is mainly through rigorous early screening, which occurs in immature children and is difficult for parents to detect because there is no pain or other discomfort at the onset of the disease and no abnormalities in the appearance of the eyes in the early stages. It is only in the late stage of the disease, when serious complications such as retinal detachment or cataract occur, that parents will notice the abnormalities in the eyes of their children when the pupil area becomes anti-white. However, by the time parents discover the abnormalities in the child’s eyes, ROP has already missed the best time for treatment and the child will be blind for life. This is why early detection of ROP is so important. How to screen for ROP early? First of all, ROP screening should be done at professional ophthalmology clinics, which usually have special ROP screening clinics in major hospitals. Secondly, we should pay attention to the time of the first screening, which usually occurs after 4 weeks of life, so the first screening time recommended by China’s ROP screening guidelines is 4-6 weeks after birth, followed by weekly or every other week review according to the ophthalmologist’s recommendation until the retina is completely vascularized. What do I need to know when I go for screening? During the screening, you will first have to dilate your pupils. It takes about an hour for newborns to dilate their pupils, so it is recommended that you arrive at the hospital as early as possible for your appointment. ROP screening at Peking University Third Hospital requires children to arrive at the screening site by 8:30 am. Second, it takes about 6-8 hours for the pupil to return to its normal size after dilatation, so try to avoid bright light stimulation during this time. In addition, do not feed your child half an hour before the examination to avoid choking during the examination. To prevent conjunctivitis after screening, the doctor will usually prescribe anti-inflammatory eye medication, which should be administered prophylactically at home, 3-4 times/day, and discontinued when there is no eye discharge for 2-3 days, or as ordered by the doctor. Do all ROPs detected by screening need to be treated? Not all ROP needs to be treated. Mild ROP only needs to be observed and most of them can subside on their own. Most of them will resolve on their own. The approximate time of regression is around 50 weeks of corrected gestational age. Only a small percentage of severe ROP needs to be treated. Is ROP treatment effective? There are two common treatments for ROP: laser and intraocular injection, both of which are effective and can basically control the progression of the disease very well. However, there are a very small number of children with ROP who are so sick that even after treatment, the ROP continues to progress to retinal detachment and requires vitreous surgery, but the treatment is not effective. Other children were not screened in time for various reasons and missed the best time for treatment, and ROP developed to an advanced stage with very poor treatment results. Therefore, it is emphasized that premature infants who meet the screening criteria must be screened in a timely and punctual manner. Do I need regular review after ROP subsides? The incidence of refractive errors such as myopia and astigmatism is high in children with ROP, and amblyopia is a common outcome if not corrected early. Therefore, it is important to pay attention to the vision of preterm infants early and correct refractive errors such as myopia or astigmatism in time to prevent the occurrence of amblyopia and strabismus. Parents should teach their children to check their vision at the age of 2-3 years old and go to the hospital for professional optometry and vision examination. cataracts and glaucoma have also been reported in children with ROP, so parents should bring their children to the hospital for professional eye examination promptly if they have any eye discomfort and reaction.