Friday, June 26, 2009

Adam's eyes

We have talked off and on about Adam's eyes and how he has follow up eye appointments. I thought I would explain what those are about. When both kids were in the NICU, they received a screening for Retinopathy of Prematurity (ROP). This test is performed on any baby born at less than 30 weeks gestation or with a birth weight under 1500 grams (3lbs). Both Adam and Sara met these parameters. ROP is an eye condition which affects the blood vessels of the retina. There are 4 stages - normal and Stage 1-3. The eye begins at the normal stage and then progressively worsens through the various stages until reverting (hopefully) back to normalcy. Mild ROP of Stages 1 and 2 are common in about 65% of preemies and settle on their own. Only a small proportion of babies develop a disease or Stage 3 which, if not treated, can seriously affect a baby's sight or cause blindness.

When a baby is born early, the blood vessels of the retina are not fully developed. After birth something triggers the blood vessels to start to grow abnormally and this forms scar tissue. The main cause of ROP is prematurity itself. The amount of oxygen treatment required and the baby's general condition may also influence whether ROP develops or becomes severe.

About an hour before the exam, eye drops are put in the eye to dilate it. The ophthalmologist uses a speculum to hold the eyelid open and places a scope gently on the surface of the eye to examine the retina. Obviously this is a little uncomfortable for them but they have handled it like troopers, probably better than I would having something propping my eye open!

Both Adam and Sara were screened for ROP initially during the week of April 20. Sara was diagnosed with the lowest stage of immaturity and had one follow up appointment after being dismissed from the hospital. Adam had a Stage 1 in his left eye and Stage 2 in the right. Visually the doctor could see a white line surrounding his retina and the veins and arteries in his eyes were more pronounced and a little "squiggly." He had 2 more exams while in the hospital and has since had 2 more after being discharged. His most recent visit indicated the left eye is now at the lowest stage of immaturity and the right eye is just a slight Stage 1 - the white line around his retina had receded. He goes back to the Illinois Eye Center for another follow up in 2 weeks. Hopefully that will be his last visit as the results this week had shown quite a bit of improvement.

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