When to screen? When should a pediatrician refer to ophthalmologist for ROP screening?
Ideally babies are to be screened at 31 weeks post conceptional age (gestational age + post natal age) or 4 weeks after birth, whichever is later.1 However, an easier way to remember is that first retinal examination should be done by first month of life. Whom to screen? Screening all premature babies will be a waste of time, as we know that all do not develop ROP. UK guidelines state that babies with gestational age (GA) £ 31 weeks or birth weight (BW) £ 1500 g should be screened for ROP. USA guidelines are GA £ 30 weeks or BW £ 1500 g. We cannot follow the western screening guidelines as in the Indian scenario we still see bigger babies getting severe ROP. So, for the Indian scenario all babies having GA £ 35 weeks or having BW £ 1800 g should be screened for ROP. Apart from this, babies that fall outside the screening guidelines but have a rough course in neonatal intensive care unit (NICU) should also be screened at the pediatrician’s discretion. This is called “sickness criteria”.
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- When to screen? When should a pediatrician refer to ophthalmologist for ROP screening?
