Extreme preterm babies at high risk of blindness

Retinopathy of Prematurity (ROP) affects up to 40 per cent of children. FILE PHOTO | NMG

What you need to know:

  • Dr Sarah Sitati, a consultant ophthalmologist at Aga Khan University Hospital says the condition referred to as Retinopathy of Prematurity (ROP) affects up to 40 per cent of children.
  • He says parents of premature children should be well informed of the risks and health problems likely to occur after birth, one of it being loss of sight.
  • During foetal development, blood vessels in the eye grow from the central part of the retina outwards; a process that is usually completed a few weeks before the normal delivery time.

Premature babies born 32 weeks or earlier and weighing less than 1,500 grammes in Kenya are at a high risk of blindness.

Dr Sarah Sitati, a consultant ophthalmologist at Aga Khan University Hospital says the condition referred to as Retinopathy of Prematurity (ROP) affects up to 40 per cent of children.

He says parents of premature children should be well informed of the risks and health problems likely to occur after birth, one of it being loss of sight.

During foetal development, blood vessels in the eye grow from the central part of the retina outwards; a process that is usually completed a few weeks before the normal delivery time. However, in premature babies the process is incomplete. In some cases the blood vessels continue with normal growth while in others it may result in abnormal growth.

“ROP is a condition that appears one month after birth. It is as a result of abnormal growth of blood vessels in the retina. This causes bleeding inside the eye triggering detachment of the retina and eventually blindness before six months. Supplemental exposure to high oxygen concentration is a risk factor for the development of the disease.”

“However, this blindness in preterm babies can be managed. Using eye drops, ophthalmologists dilate the eye and examine it through an indirect ophthalmoscope to check the retina. This procedure is conducted every two weeks until the condition regresses or blood vessels mature.

The discovery stage of the disease is a key determinant on its progression, or regression. Ten per cent of the infants diagnosed with the disease require treatment, which is done through laser therapy or injections.”

“As a preventative measure, antenatal steroids are normally administered to the mother during preterm labour to help curb health complications. After birth, taking breast milk has also been associated with reduced risk of many severe complications of prematurity.”

“The indirect opthalmoscope is available in public and private hospitals. However, there is a growing concern about clinical centres registering increased premature births and lacking the necessary equipment for diagnosis of preterm blindness. It is for this reason that we encourage mothers to visit well equipped facilities as a precautionary measure within the one month window, ” Dr Sitati notes further.

“In order to control the prevalence of the disease, the ROP National Working Group, which consists of neonatologists and ophthalmologists has started training pediatricians, ophthalmologists and nurses countrywide to be conducting this screening on preterm babies, with the first phase being launched in Nairobi.”

The training emphasises on creating awareness of ROP to mothers expecting premature deliveries as well as the importance of an eye examination on all preterm babies. It also highlights guidelines for the screening and treatment process to ensure accurate results.

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