Timeous Retinopathy of Prematurity treatment and blindness
Has your child been diagnosed with visual impairment or blindness? If your child was born prematurely, it may be due to Retinopathy of Prematurity (ROP), a disease affecting the retina that leads to visual impairment in premature infants.
The retina acts like a satellite dish that contains millions of light-sensitive cells and other nerve cells that receive and organize visual information. Your retina sends this information to your brain through your optic nerve, enabling you to see. The retina usually only finishes growing a few weeks to a month after birth. When a baby is born full-term (40 weeks gestation), the retinal blood vessel growth is mostly complete. But if a baby is born prematurely, before these blood vessels have reached the edges of the retina, normal vessel growth may stop.
For more information on Retinopathy of Prematurity see our article “The ABC’s of ROP”
Causes of ROP
Retinopathy of Prematurity is a mostly preventable and treatable disease. This condition could be caused by high oxygen levels during neonatal care, which leads to disorganised blood vessel growth in the eyes. Oxygen monitoring during neonatal care as well as ophthalmological screening to pick up the condition timeously is vital.
Babies born prior to 32 weeks’ gestation and weighing less than 1 500g have a high risk of developing the condition. Preterm infants with a low birth weight may also be at risk of ROP if they have risk factors. If their oxygen monitoring has been suboptimal, then ophthalmological screening must be considered. Screening should be performed at 4 – 6 weeks chronological age or 31 – 33 weeks post-conceptional age (whichever comes later).
Retinopathy of Prematurity can be mild or severe. In severe cases, treatment is necessary to restore the baby’s vision. It is important to assess and treat the baby before 37 weeks post-conceptional age as the damage may be irreversible after this time.
What treatments are available for retinopathy of prematurity?
There are two surgical procedures that are most often used for Retinopathy of Prematurity cases. Laser eye therapy burns the outer edges of the retina to slow or reverse the abnormal growth of blood vessels causing the baby’s visual impairment. Similarly, cryotherapy uses freezing to achieve the same purpose. In both types of treatment, the baby may lose some peripheral vision, but the process will save the centre of the eye and their sharp vision, making it a necessary sacrifice.
Treatment is essential during the disease’s early stages when the condition shows signs of worsening or the retina begins to detach. In the most severe cases, there are a few advanced surgeries available if the baby is a suitable candidate, such as a scleral buckle or vitrectomy, however early diagnosis and treatment remains the best solution.
Early diagnosis and treatment is usually undertaken within the first months of a premature baby’s life. If the opportunity for treatment is missed and the condition has reached the end stage and the retina becomes detached, vision is permanently lost.
What if the treatment does not work?
There are known cases of children who do not respond to the treatment. In these instances, ancillary treatments or surgeries to treat the effects of the visual impairment will be recommended. It is important to remember that treatment will decrease the chances of visual impairment or loss, but it does not always prevent it. However, with the correct and timeous medical care, there is a very high chance of success, with most cases reporting full vision restoration.
In addition to the devastating consequences of blindness, visually impaired children and individuals will have many extra expenses in life. A claim for compensation may be possible to cover financial loss, loss of ability to earn an income, medical expenses and pain and suffering. If your child is living with retinopathy of prematurity as a result of medical negligence and you would like to know more, contact Paul du Plessis Attorneys at 012 809 1588 or send an e-mail to paul@pauldup.co.za
Written by Dané du Plooy