My Preemie Is Being Screened for ROP (Retinopathy of Prematurity)
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published NIH, AAP, AAO guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect my preemie is being screened for rop (retinopathy of prematurity), here is what the evidence says.
The short answer
Retinopathy of prematurity (ROP) is a condition where abnormal blood vessels grow in the retina of premature babies, potentially threatening vision. It occurs because the retinal blood vessels are not fully developed at birth in preterm infants. ROP is staged 1 through 5 based on severity. Stages 1-2 often resolve without treatment. Stage 3 and above, especially with "plus disease," may require treatment with laser therapy or anti-VEGF injections. With modern screening and treatment, the vast majority of babies with ROP retain functional vision.
Key takeaways
- Retinopathy of prematurity (ROP) is a condition where abnormal blood vessels grow in the retina of premature babies, potentially threatening vision. It occurs because the retinal blood vessels are not fully developed at birth in preterm infants. ROP is staged 1 through 5 based on severity. Stages 1-2 often resolve without treatment. Stage 3 and above, especially with "plus disease," may require treatment with laser therapy or anti-VEGF injections. With modern screening and treatment, the vast majority of babies with ROP retain functional vision.
- Usually normal when: Your baby has stage 1-2 ROP and the ophthalmologist says it is regressing or stable — this is common and usually resolves
- Call your doctor if: Your baby's ophthalmologist recommends urgent treatment (laser or injection) — time is critical with aggressive ROP, and treatment should not be delayed
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
Thousands of parents search for this exact thing. You are not alone.
What Parents Should Know
According to NIH, AAP, AAO guidelines, retinopathy of prematurity (ROP) is a condition where abnormal blood vessels grow in the retina of premature babies, potentially threatening vision. It occurs because the retinal blood vessels are not fully developed at birth in preterm infants. ROP is staged 1 through 5 based on severity. Stages 1-2 often resolve without treatment. Stage 3 and above, especially with "plus disease," may require treatment with laser therapy or anti-VEGF injections. With modern screening and treatment, the vast majority of babies with ROP retain functional vision. At NICU — screening and monitoring, rOP eye exams begin at 4-6 weeks of age for babies born before 31 weeks or weighing less than 1500 grams. The exams involve dilating your baby's eyes and using a special instrument to examine the retina. These exams are uncomfortable for your baby, and watching them is difficult for parents. The exams continue every 1-3 weeks until the retinal blood vessels have matured. If ROP is detected, the stage and zone are documented to track progression. It is generally considered normal when your baby has stage 1-2 ROP and the ophthalmologist says it is regressing or stable — this is common and usually resolves. However, you should contact your pediatrician promptly if your baby's ophthalmologist recommends urgent treatment (laser or injection) — time is critical with aggressive ROP, and treatment should not be delayed.
Normal vs. Concerning
By Age
What to expect by age
NICU — screening and monitoring
ROP eye exams begin at 4-6 weeks of age for babies born before 31 weeks or weighing less than 1500 grams. The exams involve dilating your baby's eyes and using a special instrument to examine the retina. These exams are uncomfortable for your baby, and watching them is difficult for parents. The exams continue every 1-3 weeks until the retinal blood vessels have matured. If ROP is detected, the stage and zone are documented to track progression.
0-3 months corrected age
If your baby had mild ROP (stage 1-2) that resolved, follow-up eye exams are still recommended to check for long-term refractive errors (nearsightedness is more common in preemies). If treatment was needed (laser or anti-VEGF injection), close ophthalmologic follow-up continues to ensure the treatment was effective and the ROP does not recur. Most treated ROP stabilizes well.
3-12 months corrected age
Your baby should have regular eye exams to monitor visual development and check for strabismus (crossed eyes), amblyopia (lazy eye), and refractive errors, all of which are more common in premature babies regardless of ROP status. If your baby seems to not track objects visually, does not make eye contact, or you notice the eyes crossing frequently after 4 months corrected age, mention this to your ophthalmologist.
1 year+ corrected age
Most children who had ROP, even those who required treatment, have good functional vision. Annual eye exams are recommended through childhood. Premature children are at higher risk for nearsightedness, astigmatism, and other visual issues, so early detection and correction (glasses if needed) supports development. Children who had severe ROP (stage 4-5) may have significant visual impairment and benefit from early vision rehabilitation services.
What to Tell Your Pediatrician
- Describe when you first noticed my preemie is being screened for rop (retinopathy of prematurity) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you notice your baby does not seem to focus on faces or track objects by 2-3 months corrected age.
- Mention if your baby's eyes seem to cross frequently or one eye turns in or out after 4 months corrected age.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your baby has stage 1-2 ROP and the ophthalmologist says it is regressing or stable — this is common and usually resolves
- Your baby's ROP screening exams are continuing on schedule and the doctor is satisfied with progress
- Your baby had ROP that resolved and now needs routine follow-up eye exams
- You notice your baby does not seem to focus on faces or track objects by 2-3 months corrected age
- Your baby's eyes seem to cross frequently or one eye turns in or out after 4 months corrected age
- You have concerns about whether your baby can see well
- You have questions about the ROP staging or what the findings mean for your baby specifically
- Your baby's ophthalmologist recommends urgent treatment (laser or injection) — time is critical with aggressive ROP, and treatment should not be delayed
- You notice a white reflection in your baby's pupil (leukocoria) — this requires immediate ophthalmologic evaluation
What You Can Do at Home
- Keep track of when you notice my preemie is being screened for rop (retinopathy of prematurity) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby has stage 1-2 ROP and the ophthalmologist says it is regressing or stable — this is common and usually resolves — this is generally within the range of normal.
- At NICU — screening and monitoring, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if your baby's ophthalmologist recommends urgent treatment (laser or injection) — time is critical with aggressive ROP, and treatment should not be delayed.
Related Conditions
My Baby Has BPD (Bronchopulmonary Dysplasia) — Chronic Lung Disease
Bronchopulmonary dysplasia (BPD) is a chronic lung condition that primarily affects premature babies who needed oxygen or ventilator support after birth. The immature lungs become inflamed and scarred, leading to ongoing breathing difficulties. BPD ranges from mild (needing oxygen briefly after 36 weeks corrected age) to severe (requiring long-term respiratory support). While BPD is a serious diagnosis, most children's lungs continue to grow and improve over the first 2-3 years of life, and many outgrow their oxygen needs entirely.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
NICU Parent Trauma and Stress
Having a baby in the NICU is one of the most stressful experiences a parent can face. Research shows that up to 70% of NICU parents experience clinically significant anxiety or depression, and a substantial number develop PTSD symptoms. The helplessness, fear, separation from your baby, and disruption of expected parenthood are legitimately traumatic. Your pain is real and you deserve support.
Related Resources
Frequently asked questions
Is my preemie is being screened for rop (retinopathy of prematurity) normal?
When should I call the doctor about my preemie is being screened for rop (retinopathy of prematurity)?
When is my preemie is being screened for rop (retinopathy of prematurity) normal?
What causes my preemie is being screened for rop (retinopathy of prematurity)?
What should I mention to my pediatrician about my preemie is being screened for rop (retinopathy of prematurity)?
Is my preemie is being screened for rop (retinopathy of prematurity) normal at NICU — screening and monitoring?
Is my preemie is being screened for rop (retinopathy of prematurity) normal at 0-3 months corrected age?
Should I go to the ER for my preemie is being screened for rop (retinopathy of prematurity)?
Does my preemie is being screened for rop (retinopathy of prematurity) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss My Preemie Is Being Screened for ROP (Retinopathy of Prematurity).
Things to mention
- Describe when you first noticed my preemie is being screened for rop (retinopathy of prematurity) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you notice your baby does not seem to focus on faces or track objects by 2-3 months corrected age.
- Mention if your baby's eyes seem to cross frequently or one eye turns in or out after 4 months corrected age.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You notice your baby does not seem to focus on faces or track objects by 2-3 months corrected age
- Your baby's eyes seem to cross frequently or one eye turns in or out after 4 months corrected age
- You have concerns about whether your baby can see well
Urgent signs to report immediately
- Your baby's ophthalmologist recommends urgent treatment (laser or injection) — time is critical with aggressive ROP, and treatment should not be delayed
- You notice a white reflection in your baby's pupil (leukocoria) — this requires immediate ophthalmologic evaluation
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of my preemie is being screened for rop (retinopathy of prematurity) are normal. Talk to your pediatrician if your baby's ophthalmologist recommends urgent treatment (laser or injection) — time is critical with aggressive rop, and treatment should not be delayed.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
Was this page helpful?
Related Medical Concerns
My Baby Has BPD (Bronchopulmonary Dysplasia) — Chronic Lung Disease
Bronchopulmonary dysplasia (BPD) is a chronic lung condition that primarily affects premature babies who needed oxygen or ventilator support after birth. The immature lungs become inflamed and scarred, leading to ongoing breathing difficulties. BPD ranges from mild (needing oxygen briefly after 36 weeks corrected age) to severe (requiring long-term respiratory support). While BPD is a serious diagnosis, most children's lungs continue to grow and improve over the first 2-3 years of life, and many outgrow their oxygen needs entirely.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
NICU Parent Trauma and Stress
Having a baby in the NICU is one of the most stressful experiences a parent can face. Research shows that up to 70% of NICU parents experience clinically significant anxiety or depression, and a substantial number develop PTSD symptoms. The helplessness, fear, separation from your baby, and disruption of expected parenthood are legitimately traumatic. Your pain is real and you deserve support.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.