Retinopathy of Prematurity: Symptoms and Concerns Explained

Retinopathy of Prematurity (ROP)

1.
I have retinopathy of prematurity, amblyopia (one eye 0.3, one eye no light perception), high myopia (over 500 degrees), high astigmatism, nystagmus, and visual field loss.
For the past few months, I have been experiencing curved yellow-green flashes in the inner field of my right eye, sometimes continuous and sometimes not.
What could be the cause of this, and should I be concerned?
2.
Sometimes when I read, the letters appear to slightly shake, or when I look at dense straight lines, I feel a sense of movement.
Occasionally, I perceive a slight flickering of light, similar to a flickering bulb.
Is this caused by nystagmus?
3.
I find it increasingly difficult to read as the text becomes denser.
Is this due to nystagmus? Does nystagmus affect concentration?
4.
Even though I can read clearly from a distance, I unconsciously bring the text closer.
Is this because there is less visual interference and less movement when the text is closer due to nystagmus?
5.
One of my eyes has no light perception and has a white spot on the cornea.
A doctor previously mentioned that the eyeball appears somewhat atrophied, and the esotropia has become more pronounced.
Why does the blind eye's pupil appear cloudy gray-blue?
6.
During a recent eye pressure test, the eye with no light perception showed very high pressure.
What could be the reason for this? (The pressure in the other eye is also slightly high, but the eye without light perception is about 20 points higher.)
7.
A few months ago, I noticed a round lump on the eyeball when I touched the upper eyelid of the eye with no light perception while my eyes were closed.
It feels like it is on the eyeball, not the eyelid.
I have looked at the external appearance of the eyeball, and it seems normal, with no foreign body sensation and no pain.
Why is there a protrusion on the eyeball?
8.
Does a corneal opacity prevent light from penetrating, making it impossible to capture images of the fundus? However, since there is no light perception, is there still no need for examination?
9.
For individuals with retinopathy of prematurity, is it true that the retina may be subjected to traction, making it prone to slight positional shifts? Even if there is no obvious displacement of the macula, could there still be slight changes in relative position? Is this why the fundus photography may appear misaligned, due to slight differences in eye position?
10.
Is the presence of floaters since childhood related to retinopathy of prematurity? Additionally, does this condition predispose one to unstable intraocular pressure and retinal degeneration? Thank you for clarifying my doubts.

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

Dr. He Jianxian reply Ophthalmology

1.
I cannot understand your description; please consult directly at the ophthalmology outpatient clinic.

2.
The visual condition associated with nystagmus is different from that of the general population; what you are seeing may indeed be caused by the nystagmus, but I cannot be 100% certain.

3.
This condition can also occur in the general population.

4.
The tendency to look closer may be related to habit, and it is certainly also associated with comfort while reading.

5.
This is primarily due to corneal degeneration.

6.
I suspect this is caused by incorrect positioning of the intraocular pressure measurement.

7.
I recommend that you go directly to an ophthalmology examination for this type of condition.

8.
Yes.

9.
In individuals with more severe retinopathy of prematurity, the macula can indeed present various subsequent issues, so continuous monitoring and examination are necessary.

Director He Jianxian, Ophthalmology, Nantou Hospital.

Reply Date: 2023/02/19

More Info

Understanding Retinopathy of Prematurity (ROP) and its associated symptoms can be quite complex, especially for individuals who have experienced significant visual impairments. Your concerns about the various symptoms you are experiencing are valid, and I will address each of your questions in detail.

1. Flashing Lights in the Visual Field: The yellow-green flashing lines you see in your right eye could be related to several factors, including retinal detachment or vitreous traction, especially given your history of ROP. These flashes can occur when the vitreous gel pulls on the retina. It is essential to consult an ophthalmologist to evaluate the retina's condition, as this could indicate a potential issue that requires attention.

2. Visual Disturbances: The perception of letters shaking or the sensation of lines moving could indeed be linked to nystagmus (eye tremors). Nystagmus can affect visual clarity and stability, making it challenging to focus on text or straight lines. This instability can also contribute to visual discomfort and difficulty concentrating.

3. Difficulty with Dense Text: Your difficulty in reading dense text may be exacerbated by nystagmus, as the constant movement of the eyes can make it hard to maintain focus on words. Nystagmus can lead to visual fatigue, which may further impair your ability to concentrate on reading tasks.

4. Proximity to Reading Material: It is common for individuals with visual impairments to bring reading material closer to their eyes. This behavior can be a compensatory mechanism to reduce the effects of visual disturbances, such as nystagmus. When objects are closer, the visual field may appear less chaotic, making it easier to read.

5. Changes in the Appearance of the Blind Eye: The gray-blue discoloration of the cornea in your non-seeing eye could be due to corneal opacification or scarring, which can occur after trauma or due to underlying conditions. The eye may appear cloudy due to the accumulation of fluid or changes in the corneal structure.

6. Elevated Intraocular Pressure (IOP): High eye pressure in the non-seeing eye could be due to several factors, including glaucoma, which can occur in individuals with a history of ROP. The elevated pressure may not be directly related to the lack of vision but could indicate underlying ocular health issues that need to be monitored.

7. Perceived Lump on the Eyeball: The sensation of a lump on the eyeball could be due to a variety of causes, including a pterygium, a pinguecula, or even a cyst. While you may not see any external abnormalities, it is crucial to have this evaluated by an eye care professional to determine the exact nature of the lump.

8. Corneal Opacity and Fundus Photography: Corneal opacities can indeed obstruct light from reaching the retina, making it difficult to obtain clear images during fundus photography. However, since you have no light perception, the necessity for such examinations may be limited.

9. Retinal Positioning and ROP: Individuals with ROP may experience changes in retinal positioning due to scarring or traction. This can lead to misalignment during examinations, making it challenging for the ophthalmologist to obtain accurate images or assessments of the retina.

10. Floaters and ROP: The presence of floaters (often described as "seeing flies") can be associated with various conditions, including ROP. They may also indicate changes in the vitreous gel, which can be more pronounced in individuals with a history of retinal issues. Additionally, fluctuations in eye pressure can contribute to the perception of floaters.

In summary, your symptoms are interconnected and likely stem from the complex nature of your ocular history, particularly with ROP. It is crucial to maintain regular follow-ups with your ophthalmologist to monitor your eye health and address any emerging concerns. They can provide tailored advice and interventions to help manage your symptoms and improve your quality of life.

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