Retinopathy of prematurity: Practical approaches to prevent blindness

Explore the strategies to prevent and treat retinopathy of prematurity (ROP) with this online course for healthcare professionals. On this course, you will learn how a practical team approach towards neonatal care and ROP screening, treatment and follow-up can help prevent blindness in preterm babies. You will also look at how the risk of ROP and the level of neonatal care can differ between higher and lower income regions of the world.

Week 1 : Understanding retinopathy of prematurity

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Welcome to the course & Week 1

A welcome to the course from the teaching team and an initial opportunity to introduce yourself. Activities look at how we understand glaucoma and its impact on individuals and eye health services

What is ROP

Illustration of stage 4 ROP showing retinal detachment

In this activity, we first learn the definition of prematurity. We then move on to learn about retinopathy of prematurity and how the various stages and types of this complication of preterm birth are classified.

Epidemiology and impact of ROP

Graph showing regional differences in the weight and ages of preterm babies with sight-threatning ROP

A ‘third epidemic’ of ROP is affecting premature babies mainly in low- and middle-income countries with long-term effects on the children and their carers and families.

Building the ROP team

8 NICU staff smiling happily at the camera.Preventing blindness from retinopathy of prematurity requires well coordinated and multidisciplinary health care teams.  Image: Andrea Zin CC BY-NC-SA 4.0

Ensuring quality of care for preterm babies

Kangaroo care - Skin to skin contact between preterm baby with woolly hat and parent

Build your knowledge week by week on practical approaches healthcare teams can use to improve quality of care for premature babies, reduce the risk of ROP and improve outcomes. Image: Dino Abatzidis CC-BY-NC-SA 2.0

Week 2 : Investigating and monitoring glaucoma – the patient care pathway

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 Risk factors of preterm birth

Lead educators, Clare Gilbert and Daksha Patel, introducing week 2 in the video on step 2.1

Preventing premature birth is a key strategy to reduce the number of new cases of ROP

 The golden hour after birth

Preterm baby being transferred to the NICU in a travel incubator after being stabilised immediately after birthManaging the first hour of preterm life is crucial for the long term outcomes of preterm babies and reducing their risk of developing ROP.

Preventing ROP in the neonatal intensive care unit

Neonatal team discuss care in the NICU, baby sleeps in nearby incubatorProviding high quality standard care interventions in the NICU continues to improve preterm babies’ health outcomes, including reducing their risk of ROP. Image Universidad de Guadalajara CC BY-NC-SA 4.0

Ensuring quality of care for preterm babies: The PDSA cycles

Illustration of the PDSA cycles leading to decision makingLearn how healthcare teams can apply the Plan, Do, Study, Act cycles to identify whether a quality improvement intervention can work in a particular setting.

Week 3 : Screening and treatment for ROP

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Principles of screening for ROP

 Preterm baby, wrapped up in a blanket and being given oxygen, being screened for ROP by a nurse using a digital camera which is held close to the baby's eyeActive, timely screening is crucial to detect and manage ROP at an early stage after a baby is born prematurely. Image: Rajesh Pandey CC BY-NC-SA 2.0


Managing ROP screening

Ophthalmologist explains the importance of ROP screening to mother standing close by, with the baby between themThere are multiple ‘moving parts’ in ROP screening and treatment services which must all be brought together and managed to prevent blindness in preterm babies. Image: PHFI CC BY-NC-2.0  


Treatment for ROP

Illustration showing how a lens focusses a laser to ablate the avascular retina in a preterm baby's eye

The evidence base on preferred ROP treatment approaches has changed over the years, from cryotherapy to laser treatment and anti-VEGF medication.

Ensuring quality of care for preterm babies:The PDSA cycles

 Illustration of the PDSA cycles and how they lead to decision makingEvaluate a real world application of the Plan, Do, Study, Act cycles to improve oxygen saturation monitoring in the NICU.

Week 4 : Following up premature babies

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Understanding the long term ocular & cerebral complications of preterm birth

Small boy kisses his laughing twin sister who has myopia after ROP and is wearing spectacles Children born preterm must be followed up over the long term to identify and address any development delays or complications which are affecting their vision. Image: Afsane omidimorad CC BY-NC-SA 2.0


Managing ROP services and establishing programmes

Professor GVS Murthy talking about the India ROP programmeMonitoring ROP services and programmes is important to improve accountability for the use of funds and resources and to improve performance and prevent vision loss from ROP

Ensuring quality of care for preterm babies: The PDSA cycles and course summary

Illustration of the PDSA cyclesComplete an appraisal of a real world application of Plan, Do, Study, Act cycles to improve oxygen saturation monitoring in the NICU and, finally, bring together your learning from the whole course and consider your next steps.

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