Because a premature baby’s retina is incompletely developed, any premature baby, that is any baby born before 32 weeks gestation, will be visiting an ophthalmologist soon after his or her first days at home. The ophthalmologist will examine your premature baby’s eyes to check their development. With early examinations, the eye’s development can be checked to see if it is developing properly.
Parents of premature babies like to know the hows and whys of the medical procedures related to their premature baby’s health. Here are the basics of what you need to know when you preemie needs to go to the ophthalmologist:
Who is Examing My Premature Baby?: Ophthalmologist vs. Optometrist
An ophthalmologist examines a premature baby’s eyes, not an optometrist. One difference between the two is that the ophthalmologist has had 12 years of post-high school education, as opposed to the optometrist’s six years. While an optometrist can screen eyes for certain diseases, including HIV, and prescribe glasses and contacts, anophthalmologist can do all of that plus diagnose and treat all eye diseases and/or perform and necessary eye surgery.
How the Eye Works: The Body’s Camera
Light passes through the front of the eye through the cornea, pupil and lens and then through the vitreious cavity in the center of the eye. The cornea is like the focus ring on a camera, which along with the lens focus the light onto the retina at the back of the eye. Consider the retina to be the film in a non-digital camera. The retina is a delicate lining that takes a picture when focused light hits it. The picture is then e-mailed, if you will, through the optic nerve to the brain.
Why Check a Premature Baby’s Eyes?: Possibility of ROP
ROP is Retinopathy of Prematurity, which can potentially blind a premature baby. Because a premature baby’s retina did not have time to finish developing in utero, it needs to be checked to ensure it is growing properly. During this time, blood vessels which feed the retina can begin to develop abnormally, which is called Retinopathy of Prematurity. (Charles Retina Institute).
In some premature infants, ROP may lead to detachment of the retina, moderate loss of vision, nearsightedness or blindness. An ophthalmologist examines the premature baby’s eyes to screen for signs of ROP. The babies most at risk for ROP-related blindness are premature babies who weighed less than 2 pounds, 12 ounces at birth. If ROP is present, it’s best to catch it early, which is why your premature baby is at the ophthalmologist’s office so soon after his or her extended hospital release.
What to Expect
If you are squeamish, or otherwise do not like to think about eyes being touched, you may just want to skip this part. In order to check a premature baby’s eyes and retina, an ophthalmologist cannot look at a very tiny baby’s eyes the same way they use to examine an adult’s eyes. Upon your arrival, and after you’ve checked in, a nurse will administer eye drops to help numb parts of the eye before the examination. Expect to wait until the medicine has started working before being called back in for an exam.
During the preemie’s eye exam, one of the parents will have to hold the baby very still. The doctor will insert a metal round object which keeps the eye lids open. This device must be very uncomfortable, because during the procedure my premature baby cried and screamed so loudly that the piece popped out. This was unfortunate because again, the doctor had to reinsert it. Actually, they use another one as that one had touched the floor. The doctor then moves the actual eyeball so that he can see behind it. All the while, the nurse is standing there with a light in the darkened room baby is screaming and trying to get away, and you, the parent, cannot avoid watching the entire procedure.
The ophthalmologist was pleased with what he saw and had us schedule another appointment a month later to re-check our preemie’s eyes. The second visit to the ophthalmologist was not as bad because they did not have to lift the eye to check it. He has been back for a third check up, with no foreseeable problems.
Bringing your premature baby to the ophthalmologist is imperative to check on the development of the retina. When you leave the NICU, the nurse or doctor should have already made an appointment for you, if they have not, be sure to call them and get a referral. When going to the ophthalmologist, leave any discomfort you may have outside the door, and just be there soothe and console your baby during this and any other uncomfortable medical exams.