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PubMed This is a summary of 22 peer-reviewed journal articles Updated
Ophthalmology

Finding Your Footing: What is Retinopathy of Prematurity?

At a Glance

Retinopathy of Prematurity (ROP) is abnormal blood vessel growth in the eyes of premature babies. It has no outward symptoms and requires specialized screening. Fortunately, most mild cases resolve on their own, and severe cases can be effectively treated to prevent permanent vision loss.

Being in the Neonatal Intensive Care Unit (NICU) is often a time of high stress and profound anxiety for parents [1][2]. Among the many medical terms you may hear, Retinopathy of Prematurity (ROP) can sound particularly frightening. It is important to know that you are not alone in your worry, and having clear information is one of the most effective ways to manage the “panic spiral” that often accompanies a NICU stay [3][4].

Understanding ROP

Retinopathy of Prematurity (ROP) is a vasoproliferative disorder—a condition where the blood vessels in the eye grow abnormally [5].

In a full-term baby, the blood vessels in the retina (the light-sensitive layer at the back of the eye) have finished developing. In a premature baby, these vessels are still growing. ROP occurs when these vessels grow in a disorganized or “abnormal” way [5][6].

Important: ROP has NO outward symptoms. You cannot look at your baby’s eyes and tell if they have ROP [7]. The eyes will look perfectly normal from the outside. It requires an exam by a specialist using special tools to see inside the eye.

While severe ROP can lead to vision loss or blindness, the vast majority of cases are identified and managed successfully through standard screening programs [8][9].

Who is at Risk?

The likelihood of a baby developing ROP is closely linked to how early they were born and their weight at birth [10].

  • Weight: Most at-risk infants are Very Low Birth Weight (VLBW), meaning they weigh less than 1500g (about 3.3 lbs) [10][11].
  • Gestational Age: Infants born at or before 30 weeks are the primary focus of screening [7][9].
  • Incidence: While rates vary, some studies show that between 20% and 28% of infants in these high-risk groups will develop some form of ROP [10][12].

Three Stabilizing Facts

When you feel overwhelmed, keep these three established medical facts in mind:

  1. Most cases resolve on their own: The majority of ROP cases are mild (Stage 1 or Stage 2) and go away—or regress—spontaneously without any medical or surgical treatment [8][13].
  2. Screening is designed to catch it early: Hospitals follow strict national guidelines to screen infants at the exact right time (usually around 4 weeks after birth) to catch abnormal growth before it becomes dangerous [7][9].
  3. Treatment is highly effective: For the minority of babies who do need help, modern treatments like laser therapy or anti-VEGF injections (medications that slow abnormal vessel growth) are highly successful at preventing permanent vision loss [9][14].

The Emotional Journey

It is completely normal for parents to feel significant emotional distress, including symptoms of PTSD (Post-Traumatic Stress Disorder) or intense anxiety, while their baby is in the NICU [15][16]. Mothers, in particular, often report higher levels of distress [1][17].

One common fear is that watching the eye examination will be too traumatic for the parent or the baby. However, research suggests that parents who choose to be present during screenings do not necessarily experience worse psychological outcomes [1][2]. Your healthcare team is there to support both your baby’s physical health and your family’s emotional well-being [3][18].

What to Expect Next

Your baby’s medical team will perform regular eye exams using a specialized tool called an indirect ophthalmoscope or sometimes digital imaging [19][20]. They are looking for:

  • The Stage: How advanced the abnormal growth is (Stages 1 through 5) [21].
  • The Zone: Where in the eye the growth is happening [5].
  • Plus Disease: A term used when the blood vessels become twisted and dilated, which is a sign that the ROP may be progressing [5].

The most important thing you can do right now is stay informed and attend all scheduled follow-up appointments, even after your baby leaves the NICU [22][3]. For more information on understanding the findings of the eye exam, please read Decoding the Report.

Common questions in this guide

Can I tell if my baby has Retinopathy of Prematurity by looking at their eyes?
No, Retinopathy of Prematurity has no outward symptoms. You cannot tell if your baby has it just by looking at their eyes. It requires a specialized examination by an expert using specific tools to look at the retina inside the eye.
Will my baby's ROP get better on its own without treatment?
In the majority of cases, mild ROP (Stage 1 or Stage 2) resolves completely on its own without any medical or surgical treatment. Your baby's care team will closely monitor their eyes to ensure the abnormal blood vessel growth is regressing naturally.
Which babies are at the highest risk for developing ROP?
Babies born at or before 30 weeks of pregnancy are at the highest risk. Additionally, very low birth weight infants weighing less than 1500 grams (about 3.3 pounds) are closely monitored and screened for the condition.
What happens if my baby needs treatment for severe ROP?
If abnormal blood vessel growth progresses to a dangerous level, doctors use highly effective treatments to prevent permanent vision loss. These treatments typically include laser therapy or anti-VEGF injections, which help slow or stop the abnormal vessel growth.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.What is the current stage of my baby's ROP, and are there signs of "plus disease"?
  2. 2.How often will my baby need to be screened, and when is the next examination scheduled?
  3. 3.What specific signs would indicate that my baby might need treatment rather than just monitoring?
  4. 4.Does our NICU use digital imaging or telemedicine for ROP screening, and can we see the images?
  5. 5.Based on my baby's gestational age and weight, what is the likelihood that this will resolve on its own?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (22)
  1. 1

    A Comparative Analysis of Anxiety, Depression, and Hopelessness Levels in Parents After Retinopathy of Prematurity Examination.

    Akyuz Unsal AI, Bekmez S, Aydin Eroglu S, et al.

    Journal of pediatric ophthalmology and strabismus 2025; 1-8 doi:10.3928/01913913-20250530-06.

    PMID: 40736050
  2. 2

    Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis.

    Shetty AP, Halemani K, Issac A, et al.

    Clinical and experimental pediatrics 2024; (67(2)):104-115 doi:10.3345/cep.2023.00486.

    PMID: 37986569
  3. 3

    Knowledge, Attitudes and Practices of Health Workers and Caregivers Towards Retinopathy of Prematurity in Uganda: A Mixed-Methods Study.

    Lusobya RC, Atukunda I, Semulimi AW, et al.

    Public health challenges 2024; (3(3)):e208 doi:10.1002/puh2.208.

    PMID: 40496533
  4. 4

    Effects of web neonatal intensive care unit diaries on the mental health, quality of life, sleep quality, care ability, and hormone levels of parents of preterm infants in the neonatal intensive care unit: A randomized controlled trial.

    Li X, Lin Y, Huang L, et al.

    Intensive & critical care nursing 2024; (83()):103697 doi:10.1016/j.iccn.2024.103697.

    PMID: 38583413
  5. 5

    Commentary: Looking beyond anti-vascular endothelial growth factor - Novel therapeutic targets for retinopathy of prematurity.

    Dogra M, Singh SR

    Indian journal of ophthalmology 2021; (69(2)):374-375 doi:10.4103/ijo.IJO_3272_20.

    PMID: 33463596
  6. 6

    International Classification of Retinopathy of Prematurity, Third Edition.

    Chiang MF, Quinn GE, Fielder AR, et al.

    Ophthalmology 2021; (128(10)):e51-e68 doi:10.1016/j.ophtha.2021.05.031.

    PMID: 34247850
  7. 7

    Screening Examination of Premature Infants for Retinopathy of Prematurity.

    Fierson WM, , , et al.

    Pediatrics 2018; (142(6)) doi:10.1542/peds.2018-3061.

    PMID: 30478242
  8. 8

    Retinopathy of Prematurity in the University of Calabar Teaching Hospital, Calabar, Nigeria: An Early Report of a Screening Service.

    Nkanga ED, Agweye CT, Etim BA, et al.

    Journal of the West African College of Surgeons 2021; (11(3)):6-12 doi:10.4103/jwas.jwas_62_21.

    PMID: 36132975
  9. 9

    Retinopathy of Prematurity: Evolving Treatment With Anti-Vascular Endothelial Growth Factor.

    Hartnett ME

    American journal of ophthalmology 2020; (218()):208-213 doi:10.1016/j.ajo.2020.05.025.

    PMID: 32450064
  10. 10

    A Study of the Demographic Profile, Screening, and Management of Patients Visiting a Retinopathy of Prematurity Clinic.

    Mushtaq I, Agrawal T, Bhavsar D, et al.

    Cureus 2024; (16(4)):e58305 doi:10.7759/cureus.58305.

    PMID: 38752079
  11. 11

    Re: Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong.

    Chan KK, Lok JY, Yip WW, Young AL

    Hong Kong medical journal = Xianggang yi xue za zhi 2017; (23(3)):316 doi:10.12809/hkmj176306.

    PMID: 28572526
  12. 12

    Incidence, Risk Factors and Development of Retinopathy of Prematurity in Mid-Preterm and Late-Preterm Infants.

    Yenice EK, Kara C, Kavurt AS, Işleyen F

    Journal of pediatric ophthalmology and strabismus 2024; (61(5)):351-357 doi:10.3928/01913913-20240508-05.

    PMID: 38815107
  13. 13

    Clinical feature and predictive factor analysis for spontaneous regression of retinopathy of prematurity in a Chinese population.

    Li YA, Zhou XH, Cai XJ, Yang CH

    International journal of ophthalmology 2022; (15(12)):1978-1984 doi:10.18240/ijo.2022.12.13.

    PMID: 36536972
  14. 14

    Medical and developmental outcomes of bevacizumab versus laser for retinopathy of prematurity.

    Kennedy KA, Mintz-Hittner HA,

    Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 2018; (22(1)):61-65.e1 doi:10.1016/j.jaapos.2017.10.006.

    PMID: 29223789
  15. 15

    The Prevalence of PTSD of Mothers and Fathers of High-Risk Infants Admitted to NICU: A Systematic Review.

    McKeown L, Burke K, Cobham VE, et al.

    Clinical child and family psychology review 2023; (26(1)):33-49 doi:10.1007/s10567-022-00421-4.

    PMID: 36564614
  16. 16

    Prevalence and Longevity of PTSD Symptoms Among Parents of NICU Infants Analyzed Across Gestational Age Categories.

    Schecter R, Pham T, Hua A, et al.

    Clinical pediatrics 2020; (59(2)):163-169 doi:10.1177/0009922819892046.

    PMID: 31833404
  17. 17

    Mothers and Fathers in NICU: The Impact of Preterm Birth on Parental Distress.

    Ionio C, Colombo C, Brazzoduro V, et al.

    Europe's journal of psychology 2016; (12(4)):604-621 doi:10.5964/ejop.v12i4.1093.

    PMID: 27872669
  18. 18

    Nigerian neonatologists perception and experience with retinopathy of prematurity.

    Adio A, Aliyu SS, Balarabe AH, et al.

    Journal of public health in Africa 2021; (12(1)):1289 doi:10.4081/jphia.2021.1289.

    PMID: 34267892
  19. 19

    Key factors in a rigorous longitudinal image-based assessment of retinopathy of prematurity.

    Rosenblatt TR, Ji MH, Vail D, et al.

    Scientific reports 2021; (11(1)):5369 doi:10.1038/s41598-021-84723-7.

    PMID: 33686091
  20. 20

    Effect of Probenecid on Endothelial Cell Growth Rate and Retinal Angiogenesis in an Oxygen-Induced Retinopathy Model.

    Jiang J, Ou W, Luo X, et al.

    Frontiers in pharmacology 2021; (12()):717351 doi:10.3389/fphar.2021.717351.

    PMID: 34690760
  21. 21

    Incidence and Early Course of Retinopathy of Prematurity: Secondary Analysis of the Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study.

    Quinn GE, Ying GS, Bell EF, et al.

    JAMA ophthalmology 2018; (136(12)):1383-1389 doi:10.1001/jamaophthalmol.2018.4290.

    PMID: 30326046
  22. 22

    Caregiver Impact and Understanding of Retinopathy of Prematurity Screening.

    Song W, Hui M, Khitri M, et al.

    Journal of patient experience 2025; (12()):23743735251383261 doi:10.1177/23743735251383261.

    PMID: 41049119

This page provides an educational overview of Retinopathy of Prematurity (ROP) for NICU parents. It does not replace professional medical advice, diagnosis, or screening from your baby's neonatologist or pediatric ophthalmologist.

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