Baby K, 6 months old, with long eyelashes and big twinkling eyes is very attractive, but when you look closely you find that the baby’s eyes are not in you – not seeing you! Because he suffers from a special kind of eye disease – retinopathy of prematurity. What is retinopathy of prematurity? Retinopathy of prematurity (ROP) is a disease of the retinal blood vessels in the eye that occurs in premature and low birth weight infants, causing complications such as strabismus and amblyopia in mild cases, or retinal detachment and even permanent blindness in severe cases, seriously affecting the quality of life of children. Currently, ROP has become the leading cause of childhood blindness worldwide. Why are premature babies the ones who are injured? The human eye starts to develop from the fourth week of embryonic life. After 16 weeks of gestational age, the retinal vessels start to develop from the optic papilla to the peripheral part of the retina, and at 32 weeks of gestational age, the nasal retinal vessels reach the peripheral serrated edge of the retina, and at 40 weeks, they reach the temporal periphery and complete vascularization. Therefore, the younger the gestational age of preterm infants, the less well-developed their retinal vessels are. Those born at gestational age <32 weeks are more likely to develop. The younger the gestational age, the higher the incidence. Studies have shown that the incidence of prematurity is 83.4% in infants born at gestational age ≤27 weeks, 55.3% at 28-31 weeks, and 29.5% at ≥32 weeks. Those with birth weight <1500g are prone to occur. The lighter the birth weight, the higher the incidence. The incidence of birth weight <1200g is 27.3% and <1500g is 20.3%. According to the ROP international classification, the diagnosis includes the partitioning and staging of the lesion site (Zone I, II, III), severity (Stage I, II, III, IV, V), extent (expressed in clock numbers) and the presence of additional lesions (retinal vascular anger, distortion and dilatation). How is it treated? Ophthalmic treatment is based on the criteria of zoning and staging. 1. Stage I and II of zone III: regular follow-up; 2. Pre-threshold lesions: may develop rapidly and must be closely observed. 3. Threshold lesions: the key period for early treatment - the "window of time" for treatment, which can effectively prevent the progression of lesions, and treatment measures include fundoscopic condensation or photocoagulation. 4. Stage IV and V lesions: surgical treatment, such as scleral ring ligation, vitrectomy, etc. Pediatric nutritional support to prevent and treat anemia and vitamin deficiency. Screening guidelines Because the "time window" for treatment of ROP is as short as 2 weeks. Therefore, early detection, clear diagnosis and active treatment are the keys to a good prognosis for this disease. Currently, the screening criteria for ROP in China are as follows: 1. Screening by gestational week and birth weight: (1) For preterm and low birth weight infants with birth weight <2,000 g, or gestational week <32 weeks, screening for fundus lesions and follow-up until peripheral retinal vascularization; (2) For patients with serious diseases or a clear history of prolonged oxygenation, pediatricians who are considered to be at high risk can expand the screening scope. (2) For patients with severe disease or a clear history of prolonged oxygen use, the pediatrician may consider the patient to be at higher risk for screening. 2. Screening start time: The first screening should be started at 4-6 weeks after birth or 3l-32 weeks of corrected gestational age. 3. Time of intervention: After the diagnosis of threshold lesion or pre-threshold type 1 lesion is confirmed, the patient should receive treatment within 72 hours if possible, and should be referred quickly if no treatment is available. What is the prognosis? ROP does not always progress endlessly from stage I to stage V. Most lesions develop to a certain stage and then subside on their own without further development. Stage I and II lesions generally do not cause visual impairment and only need to be observed; stage III lesions, which are within the "time window" of treatment, have a better outcome. The success rate of surgery is low after the lesion enters stage V, and the child can only preserve light perception or lower visual acuity.