Retinopathy of prematurity in India appears in babies who would not be screened under the birth-weight and gestational-age thresholds used in high-income countries. Bigger, more mature infants develop severe disease here because they survive with less consistent oxygen control, and a screening net cut to a 1500 g or 30-week threshold misses them.
The national guidance is wider for that reason: screen infants born at 34 weeks or less, or weighing 2000 g or less, and screen any larger or more mature infant who had an unstable neonatal course - prolonged oxygen, sepsis, exchange transfusion, apnoea. The first examination is due by 30 days of life, and earlier for the smallest babies.
The operational failure is almost never the criteria. It is the discharge. Fix the date of the first screening examination before the baby leaves the neonatal unit, write it on the discharge summary, and give the parents a named contact, because a missed appointment at four weeks is how an avoidably blind child is produced.
- Screen at 34 weeks or under, or 2000 g or under, and widen the net for any unstable neonatal course.
- Book the first examination by day 30 of life, sooner for the smallest infants.
- Write the screening date on the discharge summary rather than leaving it to a verbal instruction.
- Give parents a named contact and explain that the baby will look entirely well when the eyes are not.
- Audit how many screened infants actually attend, not how many were referred.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ophthalmology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free