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Preterm babies begin their life not yet fully mature. As a result, eye development and growth in preterm babies may not proceed as it would for a full-term baby. The
goes through its most rapid period of growth in the first year of a baby's life. In babies born preterm, there is a higher risk of myopia development in that first year.
SEE RELATED: Baby's vision: What you need to know about your infant's eye development
By contrast, the most common type of myopia that affects children in the first and second decades of life is axial myopia. Axial myopia results from an increase in th
length of the eyeball.
There is a correlation between the amount of myopia in a preterm infant and birth weight.
Research has found that in preterm babies, myopia was 10% more likely for every 100g decrease in birth weight.
ROP results in changes to the back of the eye (retina) in preterm infants born before 31 weeks. It causes leaky, abnormal blood vessels to grow in the retina of the
infants. These leaky blood vessels can result in retinal detachment and vision loss.
MOP is a result of changes to the front of the eye in preterm infants. These changes include a very steep cornea, a thick natural lens and a smaller anterior chamb
(area between the cornea and iris). The combined effect of these changes results in myopia.
ROP is one of the leading factors associated with myopia progression in preterm babies. Vision scientists have found that severe ROP is linked to high myopia
(refractive error > – 6.00 D). ROP that was mild or went away on its own did not cause high myopia.
In a large study of premature babies (CRYO-ROP Trial), about 20% had myopia by age one. In the group of babies who had severe ROP, about 80% had myopia.
This study also found that high myopia was more likely in premature babies with severe ROP. In the overall study, less than one in 20 of 1-year-olds had high myop
the group with severe ROP, nearly one in two babies had high myopia.
Vision researchers do not know the exact process by which prematurity and ROP cause changes to the front of the eye that lead to myopia. Theories such as a
limitation of the eye’s growth or bone deficiency due to preterm birth have been proposed.
The treatments for advanced ROP include cryotherapy (freezing abnormal blood vessels), laser therapy (burning abnormal blood vessels) or an injection into the ey
that blocks the growth of new abnormal blood vessels in the retina.
Laser and cryotherapy treatments are performed in the periphery of the retina where abnormal blood vessels are found. Although these treatments decrease side v
they help to preserve central vision.
An additional side effect of ROP treatments is that they are linked with the development of myopia of prematurity. Researchers have found that the amount of myop
depends on the type of treatment.
According to the American Academy of Ophthalmology, research has shown that the more laser therapy that an infant has, the higher the risk of myopia. Cryothera
seems to increase the risk of myopia even more than laser therapy.
Another treatment, called intravitreal bevacizumab (IVB) blocks the growth of new, abnormal blood vessels. Researchers found that IVB treatment seems to cause
myopia than laser treatment.
High myopia was also less common in children treated with IVB than with laser. However, laser treatment seems to be more effective in treating ROP than IVB.
According to the American Academy of Optometry, babies born prematurely should see an eye doctor early and frequently. In general, AAO recommends that
get their first comprehensive eye exam between ages 6 and 12 months of age. This guideline is especially critical for babies who have a preterm birth.
If poor vision issues are not detected early in a young child, they may lead to irreversible vision loss due to amblyopia. It is extremely important to monitor the vision
eye health of children who have a preterm birth. As a preterm baby grows, comprehensive eye exams will ensure that any visual issues are detected early and
managed properly.
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