World Health Organization (WHO) annually celebrates World Premature Day on December 17 and draws attention to premature babies.
Retinopathy of Prematurity (ROP) is a dynamic, time-dependent disease not present at birth. The condition typically affects the eyes of pre-term babies who help save their lives by taking an intensive neonatal care (with or without oxygen therapy), but which seriously affect eye development.
The condition is characterized by the development of abnormal blood vessels in the eye retina, resulting in scarring and retinal detachment. ROP may be mild and resolve spontaneously, but in severe cases it can progress rapidly and lead to blindness.
The ROP typically starts only after two to three weeks after birth and provides a window for screening and activating the treatment at the right time, while the baby is still in the hospital under newborn care.
However, ROP can be treated with lasers if it is detected by a suitable retinal examination 30 days before delivery. "Tees Din Roshni Ke" (thirty days for Vision) should be turned into a slogan for all pre-term babies. The fact that the first retinal screening is not performed effectively and timely is a big gap that needs to be addressed. The lack of trained staff to provide effective bedside treatment, especially for babies in critical care, and then a follow-up challenge are some of the gaps that need to be addressed.
Chronic hypoxia (oxygen deficiency), intrauterine growth retardation, and prenatal and postnatal conditions are the most common triggers of ROP. Babies born below 34 weeks of gestation and weighing less than 2000 grams are particularly sensitive to ROP and should be screened within 20-30 days of delivery.
High levels of supplementary oxygen and high levels of carbon dioxide are also known to exacerbate ROP. During neonatal incubation, pre-term infants should be provided with tightly controlled and monitored blended oxygen using pulse oximeters. Other risk factors associated with this condition include anemia, bradycardia (low heart rate), blood transfusions, and intraventricular hemorrhage (bleeding to the brain).
The first incubators for preliminary terms were established in Boston in 1941 and the first ROP blind baby was immediately reported in medical journals in 1942. Since then, he had a lot of research and understanding about risk factors and his successful management. condition. Today, we have a lot of knowledge to prevent ROP blindness and achieve more than 90 percent of babies. While many babies are now being scanned for ROP and are being treated in many large and small cities of India, there are significant gaps and hence there are still many ROP-blind and visually affected premature babies.
Premature babies should have a very strict safety net to protect their potentially good vision. Gaps in this direction can cause irreversible damage and poor vision for life.
Among the common gaps, the lack of information on the ROP among the various staff of health workers and parents on the first critical days; Only the medical curriculum of some super experts, including ROP; and the lack of trained staff to provide effective treatment for infants who are still in critical care among others.
All pre-term children have a higher risk of developing further eye and vision related complications in their later life. Common disorders include retinal detachment, myopic (close vision), strabismus (cross-eye), amblyopia (lazy eye) and glaucoma.
ROP is irreversible in pre-term infants and is often a potentially preventable cause of total blindness. This disease has lifelong effects for sick children and their families. Parents, large families, doctors, nurses, and health policy makers, as well as technological advances, ensure the survival of the newborn by virtue of a great team work by following well-processed processes during critical care.
WHO stressed that ROP is an important target disease in preventing blindness program, “Vision 2020: Right to See esinde, to fight unnecessary blindness worldwide by 2020. In this world, in Prematurity Day, everyone's only innate survival "at the same time their" vision ".
(Dr. Subhadra Jalali, Director, Neonatal Eye Health Alliance, L.V. Prasad Eye Institute Network, Hyderabad. The opinions expressed are personal.
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