Does My Child Really Need to Wear These Glasses? A Review of Retinopathy of Prematurity and Long-Term Outcomes

Dawn R. Kuerschner, MS, NNP, RNC

Disclosures

NAINR. 2003;3(3) 

In This Article

Long-Term Complications of ROP

Myopia occurs in about 80% of infants with ROP.[6,42] Strabismus ("crossed eyes") and amblyopia ("lazy eyes") are also common residual findings. The prevalence of strabismus ranges from 23% to 47% in infants who have ROP. Other complications include decreased visual acuity, macular ectopia (displacement of ocular muscles), nystagmus (constant, nonvoluntary cyclical movement of the eye), retinal breaks, cataract, microcornea, and angle-closure glaucoma.[6] Macular degeneration can also lead to poor visual outcomes.[41]

The oldest surviving individuals with ROP are now in their 50s. Some experienced retinal detachment in their 20s and 30s secondary to severe myopia.[34,43] Although the oldest individuals treated with cryotherapy or laser therapy are now teenagers, there is much to be learned about their long-term complications.

Visual complications are also seen in premature infants without a history of ROP. These infants have an increased incidence of myopia, amblyopia, strabismus, and refractive errors. Strabismus is seen in 10% to 20% of premature infants who do not have ROP.[34] Premature infants also have a propensity for blue-yellow color deficits.[44]

Many infants diagnosed with ROP are prescribed corrective lenses, usually to correct myopia. Vision can be optimized by having the child wear the corrective lenses consistently. If corrective lenses are not worn, the visual field may be confined to 2 to 3 inches, denying the acquisition of information from their surroundings and delaying fine motor development.[34] Eye patching is commonly prescribed in the treatment of strabismus and amblyopia. Medications such as botulism toxin or eye drops are also used, and surgical intervention is sometimes required.[45,46,47]

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