neonatology when, how, why do you do eye screen in neonates

Why, when, how do you do eye screen in neonates? A.D.Farahani M.D Ophthalmologist Farabi RoP center Farabi eye hospital Summer ۱۴۰۴ The time of starting eye examination depends on prematurity or term delivery. ۱-Premature delivery: When and whom: Each premature baby born ≤۳۴ weeks, and or, BW≤۲۰۰۰ grams must screen ۴ weeks after birth or ۳۱th post conception, which is later. Each baby larger than this and GA ۳۴-۳۷ weeks, BW۲۰۰۱-۲۵۰۰ grams with history of NICU admission and have mentioned risk factors in Standard must screen ۴ weeks after birth or ۳۱th post conception, which is later. Who can do RoP exam: Just Certified ophthalmologist who are expert in RoP exam. Retina fellowships who are expert in RoP exam How: Pupil dilation • If possible sedation, swaddling, pacifier, sucrose • In bed screen: live exam, Tele screen (expert operator, safe net, expert reader) ۲- Term born neonates: Eye examination of term born neonates depends on history of post-natal admission and maternal history. Well baby must screen in nursery by neonatologist. If the baby has normal appearing eyes and movement, good Red Reflex and does not have any significant medical, maternal and perinatal history, neonatologist is capable of doing eye screen. If neonate has any history of: Traumatic delivery and asphyxia Consider sepsis and endogenous endophthalmitis Suspicious TORCH History of familial Cataract • Severe maternal hypertension and hypoxic-ischemic encephalopathy Chromosomal anomalies Exposure to teratogens Systemic diseases ⚫ Convulsion Congenital anomalies Must refer to pediatric ophthalmologist. Each eye examination in neonates needs pupil dilation..