We read with interest the retinopathy of prematurity (ROP) data from 1990 to 2004 from the Lothian district of Scotland (1). They state that there has been a significant reduction in those treated and trend towards reduced numbers with Severe ROP (≥ Stage 3) [1]. For infants <1000 g this may be true from the first to the second Epoch (90-94 Vs 95-99) for those treated, but in comparing the final 2 Epoch’s (95-99 and 00-04) there has been no change (Table). Approximately 30% of infants <1000 g in Lothian district developed Severe ROP and >56% of these infants were treated from 95-04 (Table). We have found that approximately 20% of infants < 1000g in New South Wales (NSW) and the Australian Capital Territory (ACT) of Australia developed severe ROP and similar to Lothian, in the later Epoch’s (98-00 & 00-02) >56% of these infants were treated (Table) [2]. Thus we feel that these immature extremely low birthweight infants are still at high risk of severe ROP and that neither the incidence of severe ROP nor those treated for severe ROP are reducing.