Retinopathy of Prematurity
Symptoms
Ideally, the disease is picked up at an asymptomatic stage by screening of at risk neonates.
However it is common that the parents directly present at a later stage with the complaints of: -
• Inability of the child to see
• Abnormal pendular or searching movements of the eyes
• White reflex in the pupillary area (when the child has the stage 5 disease which Terry had described as Retrolenticular Fibroplasia).

In modern times, with the various studies done and treatment options available, a neonate at risk developing advanced disease without having had an ophthalmic check up or referral done, can have severe medicolegal repercussions for the primary treating pediatrician or neonatologist.

Examination
The pupillary reaction is assessed with the help of torch light or the indirect ophthalmoscope with the aid of the 20 Dioptre lens for magnification. A rigid pupil that does not even respond to dilating drops is a sign of ‘Plus Disease’ (described later) indicating a tendency to progression. The neonate at risk is examined by Indirect Ophthalmoscopy. The pupil is dilated with tropicamide 0.5-1% with phenylephrine 2.5%(19). Cyclopentolate 0.5-1% can also be used(19). A single drop is instilled in each eye 5-10 minutes apart and 2-3 instillations is usually adequate(19).

Atropine drops or ointment is not to be used for dilation as tachycardia, hyperthermia or severe dehydration can occur in premature babies. In India Phenylephrine drops are available in 10% concentration and can be diluted (1:4) with distilled water or a lubricant to get a concentration of 2.5%(19).

References

Contributor Information and Disclosures

Sasha Mansukhani
(MS – Ophthal) Assistant Lecturer in Ophthalmology, Kamathipura Eye Hospital, Mumbai


First Created : 11/5/2014

References

Advertisements by :    Mega-CV by Aristo IndoIV by Sun Pharma
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.