Retinopathy of Prematurity: Impacts on Vision and Eye Health

Q: Retinopathy of Prematurity: Impacts on Vision and Eye Health

Hello Ms. Hsin： 1. This laser treatment is performed to prevent retinal abnormalities due to abnormal vascular proliferation, which may cause peripheral vision abnormalities. 2. Blood vessels are typically pulled straighter rather than becoming more curved

Retinopathy of Prematurity (ROP)

Hello, doctor.
I have retinopathy of prematurity, with high myopia and high astigmatism in my right eye, and my best-corrected visual acuity is 0.3.
My peripheral vision is relatively narrow in all directions, and there is a central vision defect of 18 dB (concentrated nasally).
My left eye has high hyperopia, with no light perception as the best-corrected visual acuity.
Both eyes exhibit nystagmus, with rapid, continuous rotation and lateral movement.
1.
What does it mean that the entire zone 3 of the retina in my right eye is completely covered by laser marks? What impact could this have? Can this indicate the extent of retinal damage and the affected areas?
2.
What are the implications of having scars on the retina?
3.
Does retinopathy of prematurity cause blood vessels to be more tortuous and dispersed?
4.
Is it possible for congenital nystagmus to worsen? Does worsening nystagmus lead to decreased vision, or does decreased vision exacerbate the nystagmus?
5.
If nystagmus requires my eyes to turn inward and upward to see clearly, and I have to tilt my head to look at things while constantly turning my eyes inward and upward, what effects could this have?
6.
Does nystagmus slow down reading speed and cause skipping lines or words, and does it reverse the order of the words I see?
7.
During fundus photography, I felt like I was looking at the point the nurse asked me to, but they said my right eye was not aligned with the point and needed to turn inward a bit more.
Why is that?
8.
Why does the blind left eye have corneal opacities, and why does the eyeball appear to be a cloudy blue and significantly esotropic (unable to fully turn outward)?
9.
Is the high hyperopia in the blind left eye due to incomplete development from blindness, or could it also be caused by ocular atrophy? Thank you for your response.

Xin, 10~19 year old female. Ask Date: 2023/02/04

Dr. He Jianxian reply Ophthalmology

Hello Ms.
Hsin:
1.
This laser treatment is performed to prevent retinal abnormalities due to abnormal vascular proliferation, which may cause peripheral vision abnormalities.

2.
Blood vessels are typically pulled straighter rather than becoming more curved.

3.
Congenital nystagmus usually develops in early childhood and theoretically does not worsen; this type of nystagmus is often caused by issues in visual development.

4.
Poor posture can easily lead to visual fatigue.

5.
Will nystagmus cause reading difficulties? It is likely unavoidable, as dynamic vision is inherently poorer than static vision.

6.
This may be due to the pulling of your retina, causing some changes in relative positioning, which may result in a different eye alignment than usual.

7.
It is likely that some atrophy of the eyeball has caused corneal opacity.

8.
This is likely due to abnormal development of the eyeball.

Director He Jianxian, Ophthalmology, Nantou Hospital

Reply Date: 2023/02/04

More Info

Understanding Retinopathy of Prematurity (ROP) is crucial for managing the visual and ocular health of individuals affected by this condition. ROP primarily affects premature infants, leading to abnormal blood vessel growth in the retina, which can result in vision impairment or blindness. Given your specific situation, let’s address your questions in detail.

1. Laser Treatment and Zone 3 Coverage: If your right eye's entire Zone 3 has been covered by laser treatment, it indicates that the retina was at risk of detachment or severe damage due to ROP. The laser treatment aims to prevent further progression of the disease by destroying the peripheral retina, which is less functional and more prone to complications. This coverage suggests that the retina in that area is no longer functioning normally, which could lead to peripheral vision loss and may affect overall visual acuity.

2. Impact of Scarring on the Retina: Scarring on the retina can lead to various visual disturbances, including distortion, reduced visual acuity, and potential areas of vision loss. Scar tissue can disrupt the normal architecture of the retina, affecting the light-sensitive cells responsible for vision. Depending on the location and extent of the scarring, it can significantly impact your visual field and clarity.

3. Vascular Changes in ROP: Yes, ROP can cause abnormal blood vessel growth, leading to vessels that are more tortuous and spread out than normal. This abnormality can contribute to complications such as retinal detachment and further vision loss. The irregularities in blood vessel formation can also lead to ischemia (lack of blood flow), which exacerbates retinal damage.

4. Progression of Nystagmus: Congenital nystagmus, or involuntary eye movement, can indeed change over time. It may become more pronounced due to various factors, including visual stress or changes in visual acuity. The relationship between nystagmus and visual acuity is complex; sometimes, worsening vision can lead to increased nystagmus, while other times, the nystagmus itself can interfere with visual clarity.

5. Head Positioning and Its Effects: Constantly tilting your head to see clearly can lead to neck strain and discomfort. This compensatory mechanism is often used to stabilize vision when nystagmus is present. Over time, this could lead to musculoskeletal issues or exacerbate any existing discomfort.

6. Reading Difficulties Due to Nystagmus: Nystagmus can indeed slow reading speed and cause difficulties in tracking text. The involuntary movements may cause words to appear jumbled or reversed, making it challenging to maintain a consistent reading flow. This can lead to fatigue and frustration during reading tasks.

7. Eye Alignment During Fundus Photography: The difficulty in aligning your right eye during fundus photography could be due to the nystagmus itself. The rapid eye movements may make it challenging to maintain a steady gaze on the target, leading to misalignment during the imaging process.

8. Corneal Opacity and Eye Appearance: The presence of a white corneal opacity and a bluish appearance in your left eye could be due to several factors, including scarring from ROP, developmental issues, or other ocular conditions. The inability to fully abduct the eye (turn outward) may indicate muscle imbalance or neurological factors associated with your condition.

9. Causes of High Hyperopia in the Blind Eye: The high hyperopia (farsightedness) in your left eye could stem from several factors. If the eye did not develop properly due to ROP, it may not have reached its normal size, leading to hyperopia. Additionally, if the eye has undergone atrophy or other degenerative changes, this could also contribute to the refractive error.

In summary, ROP can have profound and lasting effects on vision and eye health. Regular follow-ups with an ophthalmologist specializing in ROP and related conditions are essential for monitoring changes and managing any complications. It’s important to address any concerns you have with your healthcare provider, as they can offer tailored advice and interventions based on your specific visual needs.

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