History
Usually both eyes are affected. However, the two eyes can develop different degrees of severity. The course of the disease is variable: the first changes in the retina can be detected after 3 weeks. However, the maximum of the changes is around the calculated date of birth.
Prognosis
The diagnosis is made by the ophthalmologist, who routinely examines all premature babies on a regular basis. Equipped with a lamp and magnifying glass, he can look into the eyes of the little one. What may look cruel to outsiders, however, is of the utmost necessity: the so-called eyelid retractors.
The eyes are kept open by these metal bars. The pupils were dilated by medication (eye drops) in order to get an optimal view. The table above describes which findings the ophthalmologist sees in the respective stages. Of course, an inconspicuous ocular fundus is desirable. An initial examination in the 6th week of life has proven to be sufficient, since retinal damage that starts earlier is a rarity.
Therapy
It should be noted in advance that the premature baby itself requires special care. In larger clinics there are special wards for premature babies where the little ones are given appropriate medical and nursing care. Usually there is also an ophthalmologist in the house, who takes care of the retinopathy of the premature infants on site.
In order to efficiently care for a premature baby, the interaction of several medical disciplines is required. Mild forms can regress without permanent damage, such as blindness. If a severe form is present, its progression can be stopped by laser therapy.
Cryotherapy (exposure to cold) is also used here. Vessels that can grow into the vitreous body are sclerosed and their growth is stopped. Once the retina is detached, cerclages are used.
They press the retina back to its original support and promote its regrowth. For a while, the administration of vitamin E as a preventive measure was under discussion. However, studies have shown no difference to placebo administration.