Retinopathy of prematurity (ROP) screening and treatment
Retinopathy of prematurity (ROP) is a condition that can occur in premature babies when abnormal blood vessels grow in the retina. High risk babies are those born prematurely at <32 weeks, <1500 grams or required a lot of oxygen after birth. The condition can cause the retina to detach and lead to blindness. There are generally no symptoms associated with the condition, so it can only be diagnosed through an eye examination. Laser surgery is conducted in order to stop the growth of abnormal blood vessels. During the procedure, tiny laser spots are used to burn away the peripheral retina where the abnormal blood vessels are located. Cryotherapy is another surgical treatment and involves freezing the peripheral retina in order to stop the growth of abnormal blood vessels. Since laser treatment has become available, cryotherapy is very seldom used. In some cases, injecting anti-VEGF into the eye can also be performed. Dr Enslin Uys regularly examines these tiny babies and has the knowledge and experience to advise the best treatment for your baby. This usually takes place while your baby is in Neonatal ICU (NICU).
Eye tests are essential for both infants and children. To assess eye development in babies during a paediatric eye exam, the pupil response is tested to see if it opens and closes correctly, and tests are also conducted to see if the eyes are able to fix on objects and follow them as they move. There are a number of tests designed specifically for young children, such as retinoscopy. During this test, Dr Enslin Uys will shine a streak of light into your child's eye in order to see the reflection from the retina. This way Dr Enslin Uys can determine if your child needs to wear glasses as well as the strength of the spectacle correction. Random dot stereopsis is also used to determine whether a child's eyes work together, while special children eye tests (Kay chart) that make use of charts with letters and symbols are also used for necessary assessments. If your child is old enough, depth perception using the Titmus fly test, and colour vision using the 14 plate Ishihara chart can be determined. The type of test used all depends on the age of your child.
In cases where a squint cannot be repaired by other means, usually spectacle correction, surgery may be recommended. This surgery is always performed in theatre. Before the procedure, which is known as strabismus surgery, your child will be given a general anaesthetic so they won't feel any pain. During the procedure, Dr Enslin Uys will keep the eye open with a lid speculum before working on detaching the muscle that is connected to the eye. Once the muscle is detached, it can be moved into a new position so that both eyes point in the same direction. The muscles are held in place with tiny stitches that will dissolve over time. Your child may feel some sensitivity and discomfort for a few days after the surgery; however, Dr Enslin Uys will prescribe painkillers, and eye drops to relieve any pain. Dr Enslin Uys performed uncomplicated squint surgery and had this training with the world-renowned strabismologist, Prof Tony Murray. Complicated cases are better referred to colleagues who only does squint surgery (strabismologists).