Some babies are born with eye conditions, or eye problems may develop shortly after delivery. Serious eye conditions are rare, however. Before going home from the hospital, the doctor will check the baby's eyes for normal appearance, proper alignment and reaction to light. A red reflex exam in which the doctor shines a light on the retina and looks for equal red reflexes coming off the retina, will be performed. If any significant problems are found on exam, a pediatric ophthalmologist will be consulted.
Retinopathy of Prematurity
Retinopathy of prematurity,or ROP, a vascular eye disorder of premature babies, involves the blood vessels in the retinas, which is the back wall lining of the eye. For reasons unknown, in some premature babies the blood vessels do not continue to grow as they should. The blood vessels that do grow are abnormal and fragile, causing leakage and improper eye growth. According to the National Eye Institute, or NEI, premature babies most likely to be affected usually weigh less than 2 lbs., 12 oz. and are born at less than 31 weeks gestation. ROP accounts for one of the most common reasons for childhood vision loss and even blindness. About 400 to 600 infants each year go blind because of ROP, sites the NEI.
There are five stages of ROP, ranging from mild abnormal blood vessel growth to complete detachment of the retina. The NEI notes that most babies have mild to moderate disease, which resolves on its own. If treatment is required, laser therapy or cryotherapy is performed, one burning away and the other freezing the area. Both of these therapies destroy the periphery of the retina where abnormal growth occurred in the hopes of slowing or reversing it.
Conjunctivitis
Conjunctivitis is an inflammation of the conjunctiva of the eye, the thin membrane that covers the inner surface of the eyelid, and the white part of the eye, known as the sclera. Neisseria gonorrhoeae, which afflicts 30 to 35 percent of newborns born to women with gonococcal infection, is one cause of conjunctivitis, notes the book, "Core Curriculum for Neonatal Intensive Care Nursing." Chlamydia trachomatis is another infection that causes conjunctivitis. Chlamydial infections are more common in areas where poor prenatal care exists. According to the book, "Pediatric Primary Care," 50 percent of newborns born to chlamydia-positive mothers also will test positive for the disease. Erythromycin eye ointment applied to the baby post delivery is important in controlling infection rates. The symptoms of conjunctivitis usually appear between day two and five of life.
Congenital Cataracts
In infants, congenital cataracts are the main treatable cause of vision impairment. According to the Association of Women's Health, Obstetric and Neonatal Nurses, or AWHONN, cataracts are cloudy areas of any size or degree on the eye lens. Cataracts prevent light from passing through the eye lens to the focal point on the retina, thereby distorting or preventing any image to appear. AWHONN also notes that in newborns, cataracts may disappear on their own within a few weeks. A variety of conditions can cause cataracts including infections, Down syndrome, prematurity and congenital rubella. They can also be hereditary.
Nasolacrimal Duct Obstruction
Tear duct blockage occurs in 2 to 6 percent of newborn infants, according to AWHONN. The symptoms could be crusty or matted eyelashes, inflamed and swollen lacrimal sac, persistent tearing or discolored drainage from the affected tear duct area. Management includes daily massage of the nasolacrimal sac or tear duct in an attempt to rupture the imperforate membrane at the lower end of the duct. The eyes should be cleaned with moist compresses and any secretions removed.
References
- The National Eye Institute: Facts About Retinopathy of Prematurity (ROP)
- "Core Curriculum for Neonatal Intensive Care Nursing"; AWHONN; 2009
- "Pediatric Primary Care"; Catherine Burns; 2008
