Iowa Neonatology Handbook: Pulmonary

ROP Surveillance

Ronald V. Keech, MD and Edward F. Bell, MD
Peer Review Status: Internally Peer Reviewed

Because of the continuing incidence of ROP, certain infants must have their fundi examined by an ophthalmologist prior to discharge from the hospital. The PL1 resident or PNP should fill out a blue consultation sheet on the following patients at the appropriate time (see below).

Physician Guidelines for the Evaluation of Infants at Risk for Retinopathy of Prematurity

Any one of the following criteria qualifies the patient for ROP screening

• Infants with a birth weight of <1500 grams
• Infants with an estimated gestational age at birth of < 32 weeks
• Infants who do not meet the first two criteria but are deemed at risk due to other medical conditions

Method for Determining the Timing of the first ROP examination

• For infants born at < 27 weeks gestation: first eye exam at 32 weeks postnatal age (gestation age at birth + chronologic age).
• For infants born at > 27 weeks gestation: first eye exam at five weeks chronological age.

If the infant qualifies for an ROP screening but is to be discharged or transferred before the normal time for the first examination, then use the following guidelines:

If the scheduled discharge or transfer date is within two weeks of the designated time for the first ROP examination (see above), arrange for the ROP examination to be performed before discharge.

If the scheduled discharge or transfer date is more than two weeks before the designated time for the first ROP examination, then recommend a date for the first examination based on the standard criteria and include it on the ROP discharge form (Form #__).

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