What is retinopathy of prematurity (ROP), and when is screening typically performed in preterm infants?

• A. Abnormal retinal vascular development associated with prematurity; screening begins at 4–6 weeks after birth or at 31 weeks postmenstrual age, depending on gestational age.
• B. A measure of lung maturity; screening at birth.
• C. A hearing test; screening at 2 weeks.
• D. A metabolic panel; screening at discharge.

Answer: (C)

ROP is abnormal retinal vascular development that occurs in preterm infants because the retina isn’t fully vascularized at birth. The premature retina is particularly susceptible to injury from fluctuating oxygen levels after birth, which can trigger abnormal vessel growth. If this neovascularization progresses unchecked, it can lead to scarring, retinal detachment, and potential vision loss. That’s why early detection through screening is essential.

Screening is timed to catch problems when treatment can still prevent serious damage. The initial eye examination is typically started at about 4 to 6 weeks after birth or at 31 weeks postmenstrual age, whichever timing best fits the infant’s gestational age. For the most premature or smallest infants, the timing is coordinated with their PMA to ensure the retina is evaluated as vulnerability to progression is highest, while the infant is still stable for an ocular exam.

This topic isn’t about lung maturity, hearing, or metabolic screening—it's specifically about the eye and the timing of examinations to prevent vision loss in those born prematurely.