Your articles are very valid. But, these will be more meaningful if you give the practices followed in the Neonatal Units in hospitals to prevent blindness due to ROP. e.g.:

Frequency of eye examinations after birth of a premature child?
Level of oxygen and how it is administered in the incubator?
Frequency and method of monitoring?
What specific action is taken as soon as the doctor finds that ROP has started?
What alternative procedures are available to regain vision?

Such details will probably be more helpful to the communities and parents of the blind in developing world.

Regards,

Kanchan Majumdar

Dear Editor,

We read with interest the article by Haines et al.[1] We would like to add few points which can improve ROP screening programs world wide. Even though low birth weight is an important risk factor, ROP increasingly reported in higher birth weight babies also.[2]

Varying morphology of ROP also noted in especially in very low birth weight infants ( <_1000gms where="where" the="the" rop="rop" spectrum="spectrum" may="may" not="not" follow="follow" typical="typical" stages="stages" and="and" only="only" plus="plus" disease="disease" can="can" be="be" an="an" indication="indication" for="for" treatment.3="treatment.3" another="another" fact="fact" is="is" about="about" rush="rush" in="in" these="these" babies="babies" which="which" needs="needs" earlier="earlier" screening="screening" intervals="intervals" _4="_4" weeks="weeks" of="of" chronological="chronological" age.="age." p="p"> Thus We feel there should be a global consensus on screening guidelines for ROP which is emerging as an important cause of avoidable blindness in both developed and developing countries. The screening guidelines also should mention exceptional circumstances where screening is indicated like...high birth weight with hurricane postnatal period, varying morphology of disease in extremely low birth weight infants.

Training of Neonatal ICU sisters using Retcam (wide field digital fundus imaging)[4] can also help in eliminating the avoidable blindness due to ROP.

References

1. L Haines, A R Fielder, H Baker, and A R Wilkinson. UK population based study of severe retinopathy of prematurity: screening, treatment, and outcome Arch. Dis. Child. Fetal Neonatal Ed. 2005; 90: F240-F244.

2. M Minasian and A Fielder. IVF babies with ROP at higher gestational age and birth weight: implications of changing screening criteria. British Journal of Ophthalmology 2005;89:1066; doi:10.1136/bjo.2004.062935.

3. W E Schulenburg and G Tsanaktsidis. Variations in the morphology of retinopathy of prematurity in extremely low birthweight infants. British Journal of Ophthalmology 2004;88:1500-1503.

4. Yen KG, Hess D, Burke B, Johnson RA, Feuer WJ, Flynn JT. Telephotoscreening to detect retinopathy of prematurity: preliminary study of the optimum time to employ digital fundus camera imaging to detect ROP. AAPOS. 2002 Apr;6(2):64-70.