Written by: Prof. Kent Kazlo, Professional Director of the Elia Association, Developmental Optometrist.
ROP: Retinopathy of prematurity
Background (trigger or triggers)
Almost all eye development ends before birth, after birth there will be continued development that depends on the response to light. This process is especially true for the retina– the inner part (the back of the eye), is made up of receptor cells, which absorb light and transmit an electrical message to the brain. The eye begins to develop at the 16th week of gestation when blood vessels begin to develop in the center of the retina around the optic nerve. These blood vessels provide nutrition and oxygen to the developing retina and during pregnancy they grow to the retina circumference area. This development is especially agile in the last 12 weeks of gestation.
In preterm birth, the development of blood vessels may stop before reaching the circumference of the retina. So, we send a message to the rest of the retina to grow new blood vessels. But these blood vessels (neo-vascularization) are brittle and tend to bleed, causing scarring in the retina , stretching the retina and even retina separations. Therefore the damage of ROP can be between mild to most severe.
In addition to weight and delivery time, other risks to ROP are anemia, difficulty breathing, and overall health status of the anthropomomy. In the modern era, the dose of oxygen in the greenhouse is not considered a significant factor.
Medical treatment depends on the degree of ROP and requires partial destruction of the peripheral retina in order to maintain the central retina. The treatment is performed either by laser heat or by cor-cryotherapy.
There are 5 degrees of disease:
Grade 1: There are few irregular blood vessels. In most cases, vision improves with development and without treatment and reaches normal vision.
Grade 2:There is a moderate amount of irregular blood vessels. In many cases, vision is improved without treatment and normal vision is reached.
Level 3: There is a significant amount of irregular and possibly large and photo-ploted blood vessels (level 3+). For some cases there has been an improvement without intervention and treatment, but if there are enlarged and ploted blood vessels the rabbi will be treated in order to prevent retin separation.
Level 4: There is a partial rettagation. There is damage to the retin and the treatment target is to prevent further damage.
Degree 5: State of complete separation of the retina (final state of the disease). Without treatment, severe vision damage will be caused until full blindness.
Typically, the treatments described above will only be performed from the 3+ level or higher.
Rehabilitation therapy will focus on vision functions – preserving and improving vision skills, addressing developmental challenges as a result of visual impairments, including physiotherapy treatments, speech therapists, occupational therapy, necessary adjustments and working according to a personal rehabilitation program to maximize the potential and promote the child according to his ability