Can Parents Be Present During a NICU ROP Eye Exam?

Whether you can stay in the room during your baby’s Retinopathy of Prematurity (ROP) eye exam depends on the specific policies of your Neonatal Intensive Care Unit (NICU). Some units allow or invite parents to stay, while others restrict presence due to limited space, infection-control procedures, or the baby’s medical stability.

If you are allowed to stay, you likely will not be able to hold your baby during the procedure. The eye doctor (ophthalmologist) needs space to work with specialized lenses and lights to get a clear view of the retina (the light-sensitive layer at the back of the eye). Therefore, your baby will need to be positioned safely in their bed or isolette (incubator).

What to Expect During the Exam

An ROP screening is a coordinated process. Before the exam, the medical team will typically give your baby pupil-dilating eye drops to widen the pupil, and topical anesthetic (numbing) drops to reduce surface discomfort ^[1].

During the exam, the doctor uses a tool called a speculum to gently keep your baby’s eyelids open. Your baby will be positioned on their back, often supported by swaddling or “nesting.” This developmentally supportive positioning helps reduce behavioral and physiologic stress ^[2].

The exam itself is brief but can be uncomfortable for your baby. Because premature infants can experience temporary changes in oxygen levels, breathing, or heart rate during stressful procedures, the NICU team will closely monitor your baby throughout the exam. They are prepared to pause the procedure or intervene if your baby becomes unstable.

How You Can Provide Comfort (With Team Approval)

Even if you cannot hold your baby, your presence can be a source of comfort. Research shows that a coordinated approach using non-medical comfort measures can help reduce a baby’s pain and stress ^[3]. However, because premature babies can be easily overstimulated or have specific medical restrictions (like breathing tubes or IV lines), you must ask the bedside nurse for approval before trying any comfort measures.

If the team agrees it is safe for your baby, you might be able to help by:

• Offering a pacifier: Letting your baby suck on a pacifier (non-nutritive sucking), especially when combined with other soothing methods like white noise, can help calm them ^[4].
• Providing a gentle containment touch: Placing a steady, comforting hand on your baby’s head or feet can help them feel secure ^[3]. Avoid pressing on the baby, and stay clear of their face, eyes, airway, and any medical lines.
• Using your voice: Speaking or singing softly can be soothing.

While these comfort measures are helpful, they may not completely control the discomfort of the exam ^[5]. The medical team may use additional pain medications depending on your baby’s specific needs and the unit’s protocol ^[1][6].

It Is Okay to Step Out

Seeing your baby cry or experience discomfort during a medical procedure can be incredibly hard. One study noted that the procedure can be highly distressing for parents, highlighting that there is no universal rule or expectation that you must stay ^[7].

If you find it too difficult to watch, or if the unit asks you to leave, it is completely okay to step out. You can ask if you can be present for the preparation and recovery periods instead. You should discuss your unit’s policies with your care team and make the choice that feels right for you and your baby’s safety.