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Your guide to retinopathy of prematurity

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Retinopathy of Prematurity (ROP) – sometimes called ‘baby blindness’ – is a condition affecting  more than half of all babies who are born prematurely or are underweight at birth.

While most babies will only have a mild form of ROP and not require treatment, around 6% of premature babies will develop an advanced stage of ROP, which will require treatment and can result in blindness.

Abnormalities may only become apparent at a late stage. So it is vital that a doctor, nurse or practitioner examines a premature baby’s eyes every week for the known stages of development of ROP.  If this is not done, your baby has received sub-standard treatment.

A delayed diagnosis and treatment - can cause serious complications and lead ultimately to apermanent loss of vision.

If you have reason to believe that your baby was at risk of ROP but was not provided with appropriate care for any of the reasons below, you may have grounds to pursue a claim for clinical negligence.

  • A failure or delay in diagnosis
  • A failure to carry out appropriate monitoring
  • Improper use of oxygen following birth

When a mother and her baby do not receive an appropriate standard of care and treatment, it’s important to understand why the system appears to have failed them.  Seeking answers to this question requires specialist knowledge of both legal and medical issues, together with a sympathetic and sensitive understanding of how everyone involved is affected.

Your Legal Friend has many years of experience in successfully resolving different types of medical negligence cases. Our dedicated medical negligence team can help you:

  • Make your case for the injury or harm you and your baby have suffered because of negligence by a doctor, nurse, midwife or other health practitioner.
  • Obtain financial compensation to meet your needs for all necessary care, treatment, special equipment and support, both now and in the future.

Statistics for ROP show....

  • Over 60% of babies who have a birth weight of less than 1,251 grams will have ROP.             (Royal National Institute of Blind People – RNIB, 2015)
  • ROP causes between 6 and 18% of all childhood blindness in developed countries.      (Baylor College of Medicine study)
  • ROP increased tenfold in low birth weight babies, from 12.8 per 1,000 in 1990 to 125.5 per 1,000 in 2011.               
  • ROP treatment rates in low birth weight babies rose from 1.7 to 14.8 per 1,000 between 1990 and 2011.              (‘Incidence and treatment of retinopathy of prematurity (ROP) in England’, 1990-2011).

What is Retinopathy of Prematurity (ROP)?

An unborn baby’s retina - the light sensitive surface at the back of the eye) has no blood vessels until after the 16th week of pregnancy. The blood vessels continue to develop from the centre and only reach the edge of the eye one month after birth.

If a child is born prematurely:

  • The blood vessels can grow abnormally causing damage to the retina and impair vision.
  • The incomplete retina is vulnerable to oxygen damage.

To function properly, the retina needs a constant supply of blood to provide oxygen. If a baby is born early and the development of the blood vessels is incomplete, there will be areas of the retina that will not receive enough oxygen.

An insufficient oxygen supply triggers chemicals to produce new but fragile blood vessels, which leak blood and cause scarring. If left undiagnosed or untreated, the vessels can pull the retina out of position and affect a baby’s ability to see, eventually becoming completely detached and causing permanent blindness.

The five stages of ROP

A doctor, nurse or clinician should be monitoring a premature baby’s eyes for advancing stages of ROP, as follows:

Stage ONE: The outer part of the retina shows mild changes clearly marked by a flat white line dividing the abnormal area of a lack of blood supply with the normal area. Babies usually recover without any medical treatment.

Stage TWO: The damage is still contained at the outer part of the retina and considered a mild abnormality but the dividing line is now raised to form a ridge. Babies also usually recover without any medical treatment.

Stage THREE: New blood vessels start to grow on the ridge.  These vessels are very weak and will cause vision problems if they start to scar. When blood vessel growth becomes severely enlarged, laser treatment is required.

Stage FOUR: Blood vessels that have grown at stage three now shrink, causing scarring, and start to pull the retina away from the back of the eye (partial retinal detachment).

Stage FIVE: The retina can become totally detached from the back of the eye (total retinal detachment), leading to a permanent loss of vision.

Screening for babies at risk of ROP

The major reasons for babies developing ROP are:

- A premature birth and low birth weight

  • All babies less than 32 weeks or less than 1,501g birth-weight should be screened for ROP.
  • All babies less than 31 weeks or less than 1,251g birth-weight must be screened for ROP.

(Guideline for the Screening and Treatment of Retinopathy of Prematurity UK - Royal College of Paediatrics and Child Health, Royal College of Ophthalmologists  British Association of Perinatal Medicine).

- Premature babies receiving excess oxygen therapy

Premature babies are often given oxygen when they are born, particularly if their lungs are not yet fully formed. The oxygen levels in the blood of all premature babies and the amount of oxygen they receive need to be constantly monitored and carefully controlled to reduce the risk of abnormal blood vessels forming behind the retina.

ROP – do I have a claim for negligence?

A doctor, nurse or hospital clinician has a duty to provide a level of appropriate care that does not fall below an expected standard.

As Retinopathy of Prematurity (ROP) is a preventable condition,  a breach in care standards may be said to have occurred if:

  • Oxygen therapy was improperly administered after birth
  • Regular eye examinations were not provided to high risk babies
  • Symptoms of  ROP that were clearly present were not diagnosed
  • ROP was not treated promptly or adequately..

How Your Legal Friend can help you...

As experienced clinical negligence solicitors, we know that you will want to find out if the specialist failed you and your baby in their duty to provide the expected standard of appropriate care and in the diagnosis and treatment of Retinopathy of Prematurity (ROP).

We ensure your case is investigated to bring the hospital, health trust or medical practitioner to account and to secure the compensation to which you are entitled.  At Your Legal Friend, we are committedto ensuring that the victims of clinical negligence obtain answers to their questions and receive the compensation they deserve to ensure that their future medical treatment and care needs are properly met.