Retinopathy of Prematurity (ROP) is a blinding disorder affecting children caused by abnormal growth of the blood vessels of the retina. This disease affects children who are prematurely born before 34 weeks of pregnancy (against the normal term of 38 – 42 weeks). Children with retinopathy are born underweight with weight ranging much below 2000 gms. When a baby is born prematurely, retinal blood vessels can grow abnormally, causing damage to the retina. Both the eyes of the child may be affected which can eventually lead to life-long impaired vision or blindness.

Causes and effects:

Usually, the retinal blood vessels in the child’s eye starts developing after the first 16 weeks of pregnancy. The development of the eyes is fastest during the last 12 weeks of a full-term pregnancy. However, if the child is prematurely born, there could be inadequate development of the child’s retinal blood vessels. This leads to non-supply of enough oxygen and nutrients and abnormal formation of blood vessels. The abnormal retinal blood vessels can cause bleeding, retinal detachment, visual impairment, and blindness.

Identification

The Retinopathy in the new born infant is identified by a dilated fundus examination around 4 weeks after birth. Examination may be preponed by 1 week (That is at 3 weeks) in case of very low birth weight babies and  those born very early.

Management:

Management of cases of ROP involves coordination between, the neonatologist, ophthalmologist and the NICU staff

Process of examination

For clinical examination of the child for retinopathy syndrome, few drops of diluted drops are administered to the child 30 – 45 minutes before the actual examination. This process enables observation of abnormalities inside the eye of the infant.

• The retina of the child may be fully matured ensuring that the baby is safe. Follow-up checks are advised after 6 months.
• The retina of the child may not be fully developed.
• The ROP has affected the child but is not severe. Such children will be advised to close follow-ups.
• The last possibility is ROP has severely affected children thereby necessitating the need for laser / intraocular injections/surgery.

Benefits of Laser :  

ROP is a very rapidly progressing disease and hence any delay in treatment will severely impair the sight of the child. The recovery period of the ROP disease depends upon the child’s systemic condition, which once it gets stabilized, ensures total recovery. If the ROP has not affected the central part of the retina, the child will regain full vision. Only in severe cases the success of treatment will be lesser.

Statistically, it is noted that in the USA 3.9 million children are born every year of which around less than 1% of children have ROP. Most children get cured with only around 500 – 600 children becoming blind in the USA alone.

Awareness in India:

Around 38 million children are born every year in India of which nearly around 33% of the children are prematurely born. In India, the awareness of this disease is not widely spread, especially in rural areas.

Dr.Tandava Krishnan
Vitreo retinal surgeon
MaxiVision super specialty Eye Hospital
Hyderabad, Telangana state

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The human eye is a delicate organ. Eyes need constant and preventive care for them to operate at optimum levels. However, most people take eye care lightly. This should especially not be the case for the elderly. With the pandemic there have been scores of patients who prevented regular eye check-ups and delayed treatment for existing diseases which has resulted in a loss of eye health for them. Below are some eye diseases and their preventive care to follow for a healthy and happy pair of eyes especially during the pandemic times.

Glaucoma

Glaucoma can cause total blindness for the patient if not treated on time. A regular check-up is very essential for its prevention. The blindness resulting from glaucoma is irreversible. A key to curing Glaucoma is its early diagnosis and timely treatments. Tests like Applanation, Gonioscopy, Visual fields test, Retina and Optic disc checkup and Glaucoma OCT should be completed intermittently to contact the degree of disease advancement.

If you fit any category below you should get yourself checked for Glaucoma

1. People above 40 years
2. Family history of glaucoma
3. History of Myopia or people experiencing frequent change of glass power
4. History of steroid use over a long time either locally to the eye or systemically
5. History of seeing Haloes
6. Any history of injury or operation to the eyes
7. Systemic problems like diabetes, hypertension or thyroid problems
8. Any systemic or local cancer detected

Diabetic eye disease

The leading lifestyle disease of diabetes is another major cause of eye issues especially those related to the Retina. In case of any reported damage caused by diabetes tests like dilated fundus examination, retinal OCT, FFA and blood sugar status are required. Again, timely treatment is a must to avoid loss of vision.

If you are an existing patient of Diabetes ensure a regular eye check-up for the following categories,

1. History of diabetes for more than 5 years /family history
2. If you are above 40 years of age
3. Children with diabetes
4. History of Hypertension and Diabetes.

Cataract

Cataract progresses quite rapidly in the human eye. Hence, timely detection and cure are a must. Cataract patients have a tendency of developing problems related to lens like LIG (lens induced glaucoma) or Phaco-morphic glaucoma. These cause blindness if timely treatment is not delivered. Hence,  we  advise all patients to continue their timely check-ups and treatment, also surgeries if necessary. Luckily, modern cataract care  surgeries are day procedures for which hospitalization is not required. And with premium IOLs and Laser assisted surgery, the visual recovery is fast. Early cataract surgery is the choice of the day. There is a myth associated with cataract even today that one must wait till the condition is mature to which is not accurate.

Glass power

A possible change in eye power is the most ignored eye issue. This problem pertains to all with an eye number, children and adults and senior citizens. A regular eye checkup to check for a change in the power of glasses should be done 6 months in children to once in a year at the least yearly in adults. If not done occasionally the children may cultivate a lazy eye with recurrent headaches, both in children or adults.

IT Professionals

With modern day working conditions and the constant glare of screen light from laptops and mobile phone it is essential to take eye care more seriously, especially, for IT professionals. They need proper eye care as constant computer use can lead to dry eye, allergies and even headaches depending upon the sensitivity of their eyes. They need to take ophthalmologists advice periodically. Senior citizens are more prone to dry eye problems and need proper care and treatment by an eye specialist faster than young people.

So, is the case with children and college students, These days due to the pandemic most of the schools and colleges are conducting online classes and children are also getting exposed to the computer or mobile screen for a prolonged period leading. At MaxiVision we are seeing an influx of young patients with dry eye problems, irritation, frequent rubbing of eyes leading to infections and in some a condition called Keratoconus which needs early detection. They also need a proper counseling and eye examination by an ophthalmologist.

Systemic problems

Many people are experiencing systemic problems which may affect the eyes also. These systemic issues include thyroid, eye disease, hypertension, systemic use of steroids and chloroquin, congenital problems from birth and cancer. All these complications need periodic eye inspection to thwart blindness.

Doctor Recommendations

Please be aware of all the facts mentioned above and take necessary steps to have an eye examination done on time. Staying positive and healthy, taking care of your eyes and your family and to live a quality life is essential for the human race.

Dr. K. Ratan Kumar, MS (Ophthalmology)
Senior Cataract, Refractive & ICL surgeon
MaxiVision super specialty eye hospital
Madinaguda /Chandanagar, Hyderabad.
ratankuchimanchi@yahoo.in
Mobile: +91 94401 57392.

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