Retinopathy of Prematurity for Practical Nurses

Retinopathy of prematurity (ROP) is abnormal growth of blood vessels in the retina of a preterm infant. The retina normally becomes vascularized from the optic nerve outward during late gestation. Premature birth interrupts that process, leaving peripheral retina without a mature blood supply. Oxygen exposure, especially fluctuating or excessive exposure during this vulnerable period, can further disrupt normal vessel growth. Later, the avascular retina produces excess vascular endothelial growth factor (VEGF). Fragile, disorganized vessels grow into the retinal tissue and vitreous instead of following the normal vascular pattern. They can leak or bleed, and the associated fibrous tissue can contract and pull the retina away from the underlying tissue. Severe untreated disease can therefore cause retinal detachment and permanent visual loss. [1] ROP is often silent at the bedside. The infant may have no redness, discharge, apparent pain, or obvious change in visual behaviour while retinal disease is progressing. Screening is therefore based on gestational age and birth weight, not on visible eye findings. Prematurity and low birth weight increase risk, but oxygen is not something to withhold when the...