Times of India
10 June 2010
By Umesh Isalkar
Pune, India

June 10 is observed as Sight Restoration Day in Maharashtra in the memory of eye surgeon Ramchandra Bhalchandra who was committed to taking care of the poor and the downtrodden. He set an example of dedication for eradication of avoidable blindness
The main causes of blindness in children change over time. Currently, retinopathy of prematurity (ROP), which causes growth of abnormal blood vessels in the retina of prematurely born babies, is emerging as an important cause of childhood blindness, say experts. Advances in neonatal care has increased the survival rate of premature babies from what it was a few years ago. That’s precisely the reason for more cases of ROP, experts add.

“Although experts don’t completely understand the cause of ROP, it is a fact that it happens most frequently in the smallest and most premature babies,” said Col. Madan Deshpande, chief medical director of H V Desai Eye Hospital and member of the executive national board of Vision2020: Right to Sight — a platform of national and international NGOs, the Government of India and the World Health organisation (WHO) to help formulate a policy regarding avoidable blindness.

Sharing the view, retina specialist Sucheta Kulkarni said, “The incidence of ROP in premature babies is 15 to 50 per cent in western countries, while in India, it is 24 to 60 per cent. A study conducted at H V Desai hospital has shown the incidence to be around d 27 per cent.” ROP causes abnormal blood vessels to grow in the retina, the layer of nerve tissue in the eye that enables us to see. This can cause the retina to detach from the back of the eye, leading to blindness.

“If detected at an early stage, it can be corrected by laser treatment, thereby preventing blindness,” said Deshpande.

“Some cases of ROP are mild, but others require surgery to prevent vision loss or blindness. Surgery involves using a laser or other means to stop the growth of the abnormal blood vessels,” said eye expert Ashok Mahadik. Blood vessels grow from the centre of the retina of a developing baby 16 weeks into the mother’s pregnancy, and then branch outward and reach the edges of the retina eight months into the pregnancy. In babies born prematurely, growth of normal retinal vessels may be disrupted and abnormal vessels can develop, which can cause leaking and bleeding in the eye, he added.

“ROP has no signs or symptoms. The only way to detect it is through an eye examination,” said Deshpande. The goal of surgery is to stop the progression of the disease and prevent blindness. ROP surgery has a good success rate. If detected early, ROP can be arrested, he added.

Retinopathy of prematurity

• Retinopathy of prematurity (ROP) is a disease that primarily occurs in premature babies. It causes abnormal blood vessels to grow in the retina, the layer of nerve tissue in the eye that enables us to see. This growth can cause the retina to detach from the back of the eye, leading to blindness
• Babies born with less than 2 kg weight and 32 weeks of gestation should be screened by an expert retina surgeon for ROP
• The incidence of ROP in premature babies is 24 to 60 per cent in India and 15 to 50 per cent in western countries. A study conducted at H V Desai hospital has shown the incidence to be around 27 per cent
• If detected early, within six months of birth, ROP can be arrested