Nagpur: Generally, a pre-term or premature and low birth weight baby is administered oxygen for some time after birth. But this higher concentration oxygen can prove to be dangerous to the baby’s retina, and the baby can go blind if the required intervention by laser surgery is not done on time.
Dr Anand Vinekar, one of the five paediatric retinal surgeons of India, told TOI that if the problem is diagnosed in time this blindness is completely preventable through a specialized laser operation. “This problem in medical terminology is called retinopathy of prematurity (ROP). Hence, every child born in less than 34 weeks of gestation, and with less than 2kg weight, should be screened for ROP within 30 days of birth,” he said.
Dr Vinekar was in city for a CME on A to Z of ROP organized jointly by ophthalmology and paediatric departments of NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital (NKPSIMS).
“Blood vessels do not develop fully to the retina at the back of the eye in a premature baby. Retina in an eye acts like a film in a camera, and is required for vision. In stage one of the disease, a thin barrier like structure develops at the back of the eye and covers the retina. With time, this barrier grows and completely covers the retina leaving no scope for vision recovery. Hence, at stage 3, the correction of retina should be done. This allows blood vessels to grow right till the end of the retina and prevent blindness,” said Dr Vinekar.
In Karnataka, Dr Vinekar from Narayan Nethralaya has developed a model called as KID-ROP (Karnataka Internet Assisted Diagnoses of ROP) since 2007, which has benefited a lakh babies in 112 hospitals. In this model, a trained technician images the problem in the eye using a specialized imported camera costing about Rs90 lakh (now made by Forus Health in India costing Rs12-15 lakh). The image is immediately sent to eye surgeons through telemedicine system and the treating doctor is advised on the required treatment.
Dr Rekha Khandelwal, ophthalmology head, explained that the effect of the oxygen given at the time of birth begins to have its effect after 30 days. Hence, the doctor should screen premature babies after this compulsorily, and once they have detected ROP they should do the laser treatment within 48 hours.
“The doctor must catch the patient in the right window at stage three, and correct the defect using laser. But unfortunately, when the parents are told to bring the child for screening after 30 days, they don’t bring the baby as they don’t believe the doctor about the possibility of the baby going blind after this period,” she said.