PESHAWAR: The ophthalmologists at Khyber Teaching Hospital have pioneered a programme in the province to detect retinopathy of prematurity (ROP) in prematurely-born babies in early stage and prevent blindness.

“Since September 2019, we have screened 459 babies delivered before 35 weeks in nursery, neonatal intensive care unit and gynea wards and 10 of them were positive and managed,” Dr Akhunzada Mohammad Aftab told Dawn.

He said that two months ago an educated family having a baby with low-birth weight and history of exposure to oxygen in incubator in nursery was advised follow-up after a month but they didn’t do so. “Now the baby will grow blind,” he said. Had they arrived in time, the patient would have survived blindness, he added.

Dr Aftab, the assistant professor at KTH’s ophthalmology department, started the programme for the first time in the province to put brakes on the emerging cause of blindness.

He said that the treatment stopped the growth of abnormal blood vessels.

Ophthalmologist says treatment stops growth of abnormal blood vessels

He said that screening and management programme of ROP was in place all over the country but awareness was needed among the medical community as well as people to get the newly-born examined in the hospitals for the disease.

Dr Aftab said that neonates developed pupillary reflex and got their both retinas completely detached if they were not examined. “Neonates with two kilograms of weight are kept on oxygen and require examination after four weeks to exclude ROP because late presentation entails serious complications, especially loss of eyesight,” he added.

He said that ROP was one of the main topics discussed by world’s top ophthalmologists at a conference held recently in Lahore.

“On clinical examination, some need no intervention but it becomes vision-threatening if not seen by consultants to start management in case of finding symptoms. We issue cards to the babies with dates for follow-ups because any delay can cause blindness,” said Dr Aftab.

Prof Sadia Sethi and Dr Nazli Gul are two other consultants of ROP programme under which patients are treated with intravitreal anti-VEGF injections and laser free of cost.

“It causes abnormal blood vessels to grow in the retina which can lead to blindness. Some cases are mild and correct themselves but others progress to scarring pulling the retina away from the rest of the eye, which requires treatment to prevent loss of vision,” said Dr Aftab.

He said that the services were open to babies from all over the province and patients could be referred to the hospital from other districts.

“Our people visit nursery and gynea wards every day to see patients and hold counselling sessions with their parents for early detection of ROP amenable to treatment,” he added.

Dr Aftab said that the examination did not require anaesthesia but was done under anaesthesia drops for around 15 minutes and treatment sessions depended on stage of disease and complications.

“The potentially blinding disease occurs when immature retina in babies, who undergo intensive care, aren’t vascularised,” he said. He said that their exposure to supplemental oxygen halted vascular growth in retina. In developed countries, paediatricians and gynecologists reported ROP cases to the ophthalmologists.

Published in Dawn, February 6th, 2020