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Retinopathy of Prematurity
Retinopathy of Prematurity (ROP), also known as retrolental fibroplasia, is a potentially blinding condition affecting the retina of newborns. In the 1950's it was associated with the use of high amounts of oxygen in neonatal units. Today, modern neonatal care has curbed the incidence, yet because the survival rate of low birth weight infants is much higher, the exposure of surviving babies to required oxygen levels is increasing. The factors that put infants at greatest risk of developing ROP are low birth weight (less than 3.5 pounds) and premature delivery (26-28 weeks).

In babies born prematurely, the growth and development of normal blood vessels in the retina is halted and abnormal vessels may begin to develop. The problem with abnormal vessel growth, known as neovascularization, is that it does not deliver adequate oxygen supply to the retina. In addition, it may cause many secondary problems.

ROP is classified in 5 stages, depending on the extent of the disease. Progression of the disease to later stages can lead to the formation of scar tissue in the retina and complications such as: retinal detachment, vitreous hemorrhage, strabismus, and amblyopia. Many children with ROP develop nearsightedness

SIGNS AND SYMPTOMS
Because newborns cannot communicate their symptoms, parents, neonatologists, pediatricians and ophthalmologists are keenly aware of risk factors for ROP.

•Low birth weight (3.5 pounds or less)
•The need for any oxygen within the first week after birth
•Unstable health immediately after birth
Children with ROP as infants should be watched for the following symptoms that could signal underlying problems that may not surface until later:

•Holding objects very close
•Difficulty seeing distant objects
•Favoring or winking one eye
•Reluctance to use one eye
•Poor vision (previously undetected by the physician)
•Sudden decrease of vision
•Crossed or turned eye
DETECTION AND DIAGNOSIS
Infants at risk for ROP should have an ophthalmic examination at approximately 4-6 weeks of age. After instilling a series of dilating drops in each eye, the doctor examines the retina with an ophthalmoscope. The exam is often performed while a parent holds the child.

Regardless of whether treatment is required, children should be re-examined at recommended intervals to determine if the progression of the disease has halted, or whether treatment is required.

TREATMENT
Some children who develop only stage 1-2 of the disease improve with no treatment. In other cases, treatment is required if it reaches threshold. This is a term that indicates the presence of stage 3 changes.

To prevent the proliferation of abnormal vascularization, areas of the retina may be frozen with a technique called cryotherapy. Alternatively, laser may be used for the same purpose. Both treatments leave permanent scars in the peripheral retina, but they are often successful in preserving central vision.

The McMann Eye Institute is a comprehensive ophthalmology practice
offering a full spectrum of vision correction and treatment services.

McMann Eye Institute of Honolulu, Hawaii


McMann Eye Institute of Honolulu, Hawaii    McMann Eye Institute of Honolulu, Hawaii  
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The McMann Eye Institute understands how important your vision is to your life. Whether restoring, preserving, or improving sight, our eye doctors are dedicated to optimizing your vision so you can live your best. With doctors that specialize in LASIK, cataracts, glaucoma, diabetic eye care, and cornea surgical treatments, we offer our patients an extensive range of eye care services on the island of O’ahu, Honolulu, Hawaii.

In addition to performing these life changing procedures, we can also help you with simple vision problems and provide preventative vision care for you and your family. Trusted by both patients and doctors, our excellent reputation speaks for itself as we strive to provide the highest quality care in a professional and compassionate environment.

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McMann Eye Institute The Queen’s Medical Center
West O’ahu
91-2139 Ft. Weaver Rd. Suite 202
Ewa Beach, HI 96706
Phone: (808) 677-2733

McMann Eye Institute proudly serves Ewa Beach, HI and the Oahu areas of Honolulu, Waipahu, Aiea, Wahiawa, Kaneohe, Maunawili, Kahaluu, Kapolei, Iroquois Point and the remaining Hawaiian Islands and the Pacific Rim.

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Michael A. McMann, MD