Five Weeks and a Day - A NICU Story - Day 29
Day 29 - September 11, 2014
Today we receive the results of LoLa’s first eye screening for retinopathy of prematurity (ROP). Babies may be at risk for developing this disease for several reasons, some of which include prematurity (check), low birth weight (check), and exposure to high levels of oxygen (check).
In the fourth month of gestation, fetal retinal blood vessels begin forming, but the process is not complete until the baby is almost full term. During normal development, blood vessels grow
from the central part of the retina outwards. So with preemies, the baby is at risk for the vessels to grow abnormally, potentially causing them to bleed inside the eye. This causes scar tissue to form which can pull up the retina, in severe cases causing detachment of the retina and eventually blindness before 6 months. The exam allows the doctor to determine how far outward the blood vessels have grown, and if they are growing in the right pattern, which is how it is staged. There are stages 0-5 with 5 being total retinal detachment. LoLa’s doctor informs us today that she is stage 0-1. Good news, but not out of the woods, as she’ll need to be rechecked in two weeks. This, unlike most conditions afflicting preemies, doesn’t improve as she gets older and develops more, but rather the opposite. There is a good chance that since she’s at this lower stage now, it will not progress, but it needs to be rechecked to be sure.
The retina is the light catcher of the eye, doing for the eye what film does in a camera. Made of layers of nerve cells, it is actually considered part of the central nervous system (CNS), the only part of the CNS that can be visualized non-invasively. Well… just ask LoLa how non-invasive the test is… The screening for ROP is done on every preemie born 31 weeks or earlier, or those born after 31 weeks but who suffer “severe illness,” for example, respiratory distress syndrome (check) or apnea (check). After the baby’s pupils are dilated with drops, a metal speculum is used to prop open the eyelids. In order to check all parts of the retina, the doctor has to depress the eyeball with a metal tool while viewing the retina through a special lens called an opthalmoscope that shines a bright light straight into her eye. Sounds super non-invasive, right? This lionhearted little one braves this test like the fierce little fighter she is.