Ophthalmology

Hi, We were discussing the practice of eye examinations in our unit in regards to infant discomfort. Right now we give cyclopentolate 0,5% -phenylephrin 0,5% drops, 1 in each eye, at 45 and 30 minutes before examination. If the opthalmologist chooses to do a full exam with RetCam they also give local anasthetics. Since we see a lot of problems with desaturations and instability with the children post-exam, we are considering to only give 1 drop in each eye at 45 minutes pre-exam, this has been implemented at another hospital in the region. But we were also discussing the possibility of sedation during the exams to minimize discomfort of the infant. A colleague suggested …

Good time for you, dear colleagues! I wish to ask about your Bevacizumab and Ranibizumab experience in ROP. Some earlier we star Ranibizumab injections in babies with ROP. We used it with local anesthetic expose in our third case. It was very easy for us and baby, especially for his respiratory statues (severe BPD, with PH in anamnesis). Innovation for us was no general anesthesia for Lucentis injections use. All our colleagues use fentanyl, ketamin and other intravenous anesthetics in same cases. If you Avastin or Lucentis use in ROP treatment, what type of anesthesia you prefer? Many thanks for your attention. Sorry. With good result for both …

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Alex replied August 4, 2024Aug 4

In the maternity ward I sometimes come across babies with irregular pupillary shapes. Not like coloboma but the other way around - small black circles outline the pupil. Whenever I refer these findings to the ophtalmologist they don´t see it so I have´nt got a name for it. Does any of you have the same experience? Do you know what it is?

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Urban Rosenqvist replied December 14, 20186 yr

Dear members Are you still recommending prophylactic eye drops for opthalmia neonatorum(esp Gonococcal conjuntivitis)? What is the rational in doing so. What is the current recommendation. Still silvernitrate eye drops in practice any where! Dr jaleel

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nashwa replied November 4, 201410 yr

Is anyone using winrop ( https://winrop.com/ ) ? REF: http://pediatrics.aappublications.org/content/123/4/e638.full.pdf#page=1&view=FitH

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selvanr4 replied March 18, 201410 yr

I just wanted to link to the 2013 Guidelines for ROP Screening issued by AAP http://pediatrics.aappublications.org/content/131/1/189.long Has anyone modified practice after the new guidelines have come out ?

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JACK replied May 16, 201311 yr

We are doing our Laser Retinal Photocoagulation in our NICU in a pre-designed area. I just wanted to know where other NICUs are doing their Laser therapies? (NIICU or OR) DO you have a special area marked for Laser? If doing Laser in NICU how do yo manage to comply with Laser safety regullations? How do you ensure safety of other staff in NICU during the laser?

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sudershan.kumari replied January 31, 201312 yr

I read a paper here: http://www.ncbi.nlm.nih.gov/pubmed/22370669 Tlucek PS, Grace SF, Anderson MP, Siatkowski RM. Effect of the oxygen saturation target on clinical characteristics of early- versus late-onset retinopathy of prematurity. J AAPOS. 2012 Feb;16(1):70-4. PubMed PMID: 22370669. Now I am getting more confused...

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Francesco Cardona replied June 29, 201212 yr

I assume like other big NICUs out there with decreasing mortality of preterms (especially the extreme preterms), the incidence of ROP continues to increase...with some cases progressing to threshold disease requiring laser photocoagulation. Though ROP seems to be more prevalent in our extreme preterms with CLD (Chronic Lung Disease) - (anecdotal opinion), we also have plenty of preterms who had a short ventilation with quick weaning and a relatively smooth course who also ended up developing threshold ROP. Our main ROP prevention strategy aims at oxygen therapy - avoidance of exposure to high SpO2. I wanted to know how my colleagues in other NICUs around th…

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JACK replied September 27, 201113 yr

Baby with retinopathy which started in 33 postnatal weeks in plus disease resistant to laser therapy. Was born in 26-27 weeks with 800 g weight (early on set sepsis, NEC I stage of Bells, heart ventricular septal defect (corrected spontaneously). Have a question. Do have experience with AVASTIN (Bevacizumab)? What impressions to you? Many Thanks?

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Alex replied January 4, 201015 yr