Retinopathy of prematurity: who to screen and when
- Topic
Premature babies' retinas are not fully grown and can develop abnormal vessels. In Colombia every baby born before 33 weeks is screened.
See it in 3D: Retina
What it is
Retinopathy of prematurity is abnormal growth of retinal vessels in premature infants, whose retina is not yet fully vascularised at birth. Oxygen exposure and illness disturb normal growth, and the ischaemic retina then grows abnormal vessels that can pull the retina off. It is a leading cause of preventable childhood blindness in middle-income countries. Screening by an ophthalmologist and timely laser or injections prevent most blindness.
Key facts
- Colombian guideline: screen all infants born before 33 weeks of gestation.
- Infants born at 33 to 36 weeks are screened if they have any other risk factor (oxygen, ventilation, transfusions, anaemia, serious illness); if in doubt, screen.
- First exam at least 4 weeks after birth and after reaching 32 weeks of postmenstrual age.
- Exam by indirect ophthalmoscopy by a trained ophthalmologist, with anaesthetic drops for pain.
- Follow-up continues until the retina is fully vascularised or the disease has regressed or been treated.
In clinical practice
- In Bogotá, unlike high-income countries, babies born after 32 weeks still develop sight-threatening disease, which is why the Colombian criteria are wider.
- Controlled oxygen targets reduce retinopathy; the Colombian guideline advises against early erythropoietin, which raises its risk.
- Treatment of severe disease (laser to the avascular retina or anti-VEGF injection) is urgent, within days of detection.
Next step / Initial management
- Neonatal units: identify every eligible infant and book the first exam on time; the exam cannot wait for discharge.
- Infant discharged before screening is complete: guarantee the follow-up appointment before discharge.
- Treatment-requiring disease: treatment within days by a retina or paediatric ophthalmologist.
- After regression: long-term follow-up for myopia, strabismus, amblyopia and late detachment.
Test yourself
Think of the answer, then tap the question to see it.
Which infants should be screened for retinopathy of prematurity in Colombia?
All infants born before 33 weeks, and those born at 33 to 36 weeks with any other risk factor.
When is the first screening exam done?
At least 4 weeks after birth and after reaching 32 weeks of postmenstrual age.
Why are Colombian criteria wider than those of high-income countries?
Because local data show sight-threatening disease in babies born after 32 weeks.
Connections
See it in 3D1
The structures of Durgical's 3D anatomy where it is found.
Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once.
Sources: Guía de práctica clínica del recién nacido prematuro (Guía No. 04) (Ministerio de Salud y Protección Social de Colombia, 2013); Retinopathy of Prematurity (StatPearls Publishing (NCBI Bookshelf), 2025).
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Representative model, for educational purposes only.