Blindness risk for premature babies

ADVANCES in neo-natal medicine are saving the lives of increasingly premature babies, but resulting in a higher risk for the children of blindness and visual handicap.

Those affected are either completely blind or suffer serious vision defects because the blood vessels in their eyes are not fully developed at birth and rupture, damaging the retinas. The numbers are increasing.

Strong lighting in special baby-care units may be a contributory cause, according to Alistair Fielder, Professor of Ophthalmology at the University of Birmingham, who wants to set up a collaborative study with US specialists.

The condition is known as retinopathy of prematurity, or ROP, and affects babies born at 31 weeks of gestation or earlier, but is not detectable until three to six weeks after birth.

It afflicts 6.4 per cent of all visually impaired children under 16. This means there are at least 1,200 affected children in Britain and the number is probably increasing by about 30 a year.

The earlier a baby is born the more likely a risk of ROP; some babies born at 24 weeks are now surviving. About half of all premature babies are known to show symptoms. The majority cure themselves, but 1 per cent will suffer visual handicap.

Professor Fielder said: 'The amount of illumination that babies receive while in intensive care can be more than 10 times that of office illumination. In addition, this is 24 hours a day and it occurs when the baby would normally still be in the darkness of his mother's womb.

'If this is a cause we need to know because one of the easiest things to do will be to turn lights down in neo-natal units,' he said. He found that the part of the retina damaged is that which is not protected by the eyelids.

A second initiative has been started by Mr Edmund Schulenburg, consultant ophthalmologist at London's Hammersmith Hospital, using cyrosurgery, which involves freezing the retina and destroying abnormal blood vessels with a special lance he has developed.

He claims a 75 per cent success rate but the operation has to be carried out during a brief stage of the eye's development which lasts for only seven to 10 days. 'The question of improved care for premature babies is now posing a serious dilemma for the medical profession,' he said.

'This is directly related to the medical profession's ability to save these very premature babies and there is a heavy price to pay for it. Yet where do you draw the line? Many . . . mature normally.'