Doctors in Pakistan are calling for nationwide screening of premature babies for retinopathy of prematurity (ROP), warning that delayed diagnosis and treatment can lead to preventable childhood blindness.
According to the Department of Pediatric Ophthalmology and Strabismus at Al-Shifa Trust Eye Hospital in Rawalpindi, advances in neonatal care have improved the survival of premature infants.
However, doctors say the growing number of premature babies surviving intensive neonatal care has also increased the population at risk of ROP.
The hospital estimates that nearly 1 million babies are born prematurely in Pakistan each year, while around 300,000 may develop varying degrees of ROP. Doctors say thousands of affected infants may require specialized treatment, including sight-saving surgery in advanced cases.
What is retinopathy of prematurity?
ROP is an eye condition that primarily affects babies born prematurely and can cause permanent vision loss if it progresses without timely detection and treatment.
Blood vessels in the retina normally develop during pregnancy and complete their growth around full-term birth. When a baby is born prematurely, this process can be interrupted, potentially leading to abnormal blood vessel growth in the retina.
In severe cases, these abnormal vessels can damage the retina and result in irreversible blindness.
Babies with very low birth weight are among those at higher risk. The doctors cited in the report identified babies weighing less than 1.5 kilograms at birth as particularly vulnerable.
Doctors call for nationwide ROP screening
Dr. Amjad, a pediatric ophthalmologist and ROP specialist at Al-Shifa Trust Eye Hospital, said Pakistan does not currently have a nationwide ROP screening program despite the large number of premature births.
He called for routine eye examinations for premature infants so that ROP can be detected before it reaches an advanced stage.
Early screening is important because ROP may not produce obvious signs that parents can identify themselves. Specialized examination by trained medical professionals is therefore needed to determine whether an infant has the condition and whether treatment is required.
India cited as example for ROP screening
Dr. Amjad pointed to India as an example of how systematic screening can help reduce ROP-related blindness.
According to the specialist, India introduced mandatory eye examinations for premature babies before discharge from neonatal intensive care units, contributing to a reduction in blindness associated with the condition.
The experience has prompted calls for Pakistan to establish a similar nationwide screening framework for high-risk premature infants.
ROP treatment requires specialized facilities
Advanced ROP cases can require highly specialized medical care, including pediatric ophthalmologists trained in retinal procedures, specialized anesthesia teams and appropriate surgical facilities.
Al-Shifa Trust Eye Hospital says it is currently the only facility in Pakistan performing these highly specialized ROP surgeries.
The Rawalpindi-based hospital carried out approximately 560 ROP surgeries free of cost during the past year, according to the information provided by the institution.
Doctors, however, say this figure represents only a small proportion of the infants estimated to need treatment.
Why early ROP detection matters
Doctors emphasize that ROP does not necessarily lead to blindness in every premature baby. The risk and severity depend on factors including the degree of prematurity, birth weight and the development of the baby’s retinal blood vessels.
The condition can, however, become sight-threatening when severe disease is not identified and treated at the appropriate time.
A nationwide screening system could help identify high-risk infants earlier and ensure they are referred to appropriate specialists when treatment is needed.
The call from pediatric eye specialists comes as improvements in newborn intensive care continue to increase the survival of premature babies in Pakistan, highlighting the need for corresponding access to specialized eye screening and treatment.
