‘500 kids go blind in India every year due to late detection’

Retinopathy of prematurity (ROP) can be prevented very easily, but 500 children go blind because of it every year.

November 17 is observed as World Prematurity Day. With advances in neonatal intensive care, the survival rate of premature babies has increased. But unfortunately, the incidence ROP has increased.

Despite all odds, the child survives, but it becomes blind because of poor awareness.

For this very reason November 17 is a very important day for the International Agency for the prevention of Blindness (IAPB).

This was very important because child remained blind for life, means more than 70 years.

If the disease is detected late then there is no cure of this kind of blindness. There is no disease at birth. Disease appears after birth. There is a window period during which the disease can detected by examining the eyes and medically managed to reverse the progression of the disease

Vitreo-Retina and Uvea Specialist with the L.V. Prasad Eye Institute Sameera Nayak said that ROP-related blindness constituted 3.5% to 18% of all childhood blindness. There were more than 50,000 children affected globally with ROP and 500 children go blind in India. This estimate is based on blind schools survey, so this was just the tip of the iceberg, the actual burden is much more, she felt.

Primary cause

The primary cause for ROP was (hormonal) imbalance of IGF (Insulin like growth factor-I) and VEGF(Vascular endothelial growth factor). Initially, in the mother’s womb the IGF-I and VEGF levels were normal causing normal vessel growth and normal retina.

The balance is lost when the baby is born premature leading to abnormal blood vessels in retina, Dr Sameera explained.

The disease was tricky because most of the affected children behaved normally with very good visual acuity after early intervention. Day 30 and day 20 strategy is followed for premature baby retina examination.

Screening

All pre-term babies less than 36 weeks of gestation should be screened at 30 days of their birth whereas all pre-term babies less than 30 weeks of gestation should be screened at 20 days of birth.

Screening could be done in the neo-natal intensive care unit (NICU) or the outpatient department. Baby’s eye examination had to be done by a retina specialist or paediatric ophthalmologist who had special training for ROP screening.

One time retina examination was not sufficient, some babies needed multiple examinations.