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Screening key to halting vision disorder in premature infants

By Jessica Pasley
January 2010

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Retinopathy of prematurity (ROP) is the leading cause of irreversible blindness in children worldwide. If detected early, it can be treated.
But the diminishing number of trained specialists to screen premature babies for ROP is making it a tough condition to manage.

“It is becoming increasingly more difficult for NICUs to retain appropriate physician coverage to provide these exams,” said Franco Recchia, M.D., chief of the Retina Division at the Vanderbilt Eye Institute (VEI).

Nationally, the number of ophthalmologists performing screening exams for ROP has dropped by half, said Recchia. Thankfully, Vanderbilt sees things differently, he said. As other hospitals are cutting back on screenings, VEI specialists are stepping up.

Recently Vanderbilt began providing eye care screenings for Erlanger Children’s Hospital in Chattanooga, Tenn.

“We felt that this was an important enough service for the good of these children and we were very willing to provide the services,” said Recchia.
“We know that most children who are born early will develop some degree of ROP. While it usually regresses spontaneously, there are still a significant number of patients who are at risk for vision loss if not treated with laser surgery.

“Of the babies we screen, about 10 percent require laser treatment and we do this procedure within 48 hours of diagnosis,” Recchia said. “When correctly applied, it reduces the chance of an unfavorable outcome by 90 percent.”

Recchia said that as advances in neonatal care grow, more fragile children are surviving.

“The overall incidence of ROP has not increased, but we are seeing more severe cases because the younger these babies are born and the smaller they are, the more at risk they are for developing severe ROP.”

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