Important Vision Screening for Preemies

For Nile Barrett, being able to see and play like other one-year-olds his age is something his parents thought might never happen. But new technology helped doctors make an early diagnosis that dramatically changed the course of his short life.

“He's like a miracle baby,” said Nile’s mother, Tarah Barrett. “He's amazing; just extremely bright, very playful, very loving, just aware of everything that's going on around him.”

Nile was born four months early, weighing only 1 pound, 8 ounces. His lungs were not yet fully developed, so Nile had to be intubated and given oxygen from the very start — which actually compromised his eyesight.

Soon after his birth, Dr. Paul Chan, an ophthalmologist at NewYork—Presbyterian/Weill Cornell Medical Center in New York diagnosed Nile with retinopathy of prematurity, or ROP.

“It affects the vasculature of the developing retina, and the problem is if the abnormal vessels start to grow, they can start to elevate and cause renal detachment,” said Chan. These abnormal blood vessels are fragile and can leak, scarring the retina and pulling it out of position.

When a baby is born full-term, the retinal blood vessel growth is mostly complete, but the retina is not finished growing until a few weeks to a month after birth. If a baby is born prematurely before these blood vessels have reached the edges of the retina, normal vessel growth may stop depriving it of essential oxygen and nutrients.

ROP, which usually develops in both eyes, is one of the most common causes of visual loss in childhood and can lead to lifelong vision impairment and blindness. It affects nearly 15,000 newborns in the United States each year, and is the same condition that took the eye sight of legendary musician, Stevie Wonder.

Infants with ROP are considered to be at higher risk for developing certain eye problems later in life, such as retinal detachment, myopia (nearsightedness), strabismus (crossed eyes), amblyopia (lazy eye) and glaucoma. In many cases, these eye problems can be treated or controlled, but because there are no real signs or symptoms of ROP, Dr. Chan said it is very important that babies get screened.

“If children at risk for ROP are not evaluated appropriately in a timely fashion, they can go blind. And if they're extremely low birth weight, and they're less than 750 grams — very, very young at birth — they're at highest risk,” he added.

Dr. Chan credits early detection and diagnosis of Nile’s condition to his use of new digital imaging device, called a RetCam. It’s a device that is helping doctors visualize changes in the eyes to diagnose and treat patients before it's too late. The RetCam provides health care professionals with an easier alternative to the traditional ophthalmoscopy and can be easily performed by nurses, technicians in the intensive care unit or operating room.

“It doesn't just help us manage patients clinically, in terms of helping me see sequential changes... of what the changes are in the retinal vasculature, and what the blood vessels are doing,” said Chan. “It's incredibly helpful in educating families and helping them understand exactly what's happening to their baby.”

Days after Nile's diagnosis, Dr. Chan preformed laser surgery to correct his vision.

“His retina looks fabulous and his central vision is saved so I think Nile is going to have great future,” said Chan.