How to Treat Increasing Retinopathy of Prematurity and Infantile Strabismus

Pediatric eye diseases are increasing day by day. However, children are often unaware of their visual abnormalities and often do not express their vision problems even when problems arise. During childhood and adolescence, people around them, such as guardians, must quickly recognize the signs of eye abnormalities and provide appropriate treatment and management.

Retinopathy of Prematurity

Retinopathy of prematurity is a general term for eye diseases that occur in premature babies born before the retinal blood vessels are fully developed. Gestational age at birth, body weight, and excessive oxygen intake are important risk factors for retinopathy of prematurity.

With recent advances in obstetrics and neonatal medicine, the survival rate of high-risk, low-birth-weight infants has increased, and the incidence of retinopathy of prematurity is on the rise again. Retinopathy of prematurity occurs in approximately 25% of all premature babies, but most cases resolve naturally without special treatment.

The American Academy of Ophthalmology recommends that the first examination be performed between 4 and 6 weeks after birth or between 31 and 33 weeks of gestational age. As the disease progresses, treatment outcomes worsen, so timely treatment after diagnosis is important.

Treatment Options

Laser photocoagulation, currently used as the primary treatment for retinopathy of prematurity, aims to reduce retinal oxygen demand and the expression of vascular growth factors by irradiating a laser on avascular retinal areas.

However, this treatment has the disadvantage that the laser leaves scars on the peripheral retina, which impedes retinal vascularization in avascular areas and may cause peripheral vision defects in the future.

Intravitreal injection of anti-vascular endothelial growth factor is simpler and less time-consuming than the existing laser photocoagulation, leaves no scars on the retina, can relatively preserve peripheral vision, and has normal blood vessels in avascular areas.

Infantile Strabismus

Strabismus is a condition in which the two eyes are not aligned and look in different directions. If one eye is turned outward it is called esotropia, while if one eye is turned toward the nose it is called esotropia.

Common causes include abnormalities in the muscles that move the eyes, trauma, and brain disease, but there are many cases in which the exact cause is unknown despite detailed examinations.

Treatment Options

Treatment for pediatric strabismus varies depending on the type and degree of strabismus. Typical treatments include the use of glasses, masking treatment, or surgical treatment.

Glasses may be effective for esotropia caused by hyperopia. Wearing glasses for hyperopia prevents the eyes from over-adjusting and helps prevent them from turning inward.

Occlusion treatment involves protecting the eye’s function and preventing amblyopia by covering the clearly visible eye with an eye patch and allowing the patient to see only objects with the opposite strabismus.

Surgical treatment is a method of weakening or strengthening the strength of the muscles that move the eyes by adjusting the attachment points to realign the eyeball.