Testing tool to detect baby's eye disease

“It's like you're peeling back the layers of an onion,” is how Lee, of Children's Hospital Los Angeles, describes a mysterious disease's damage to the child's eye.

Now a few doctors around the U.S. are testing a new tool that lets them, for the first time, watch how this disease that blinds hundreds of premature babies every year begins its sneak attack behind their tiny eyelids. It's technology that offers hope of one day helping to save more children's vision.

Already the researchers are astonished to learn how much damage this disease — called retinopathy of prematurity, or RoP — can do before today's standard preemie eye exams signal a reason to worry.

“We can see just amazing things in these young children's eyes that we never suspected,” says Dr. Cynthia Toth of the Duke Eye Center.

New understanding of this eye disease is crucial. About 16,000 premature babies a year in the U.S. get some degree of RoP, and it on the increase. Why? The smaller the preemie, the bigger the eye risk, and doctors are saving more and more of the estimated 28,000 babies a year who are born weighing 2} pounds (0.91 kilograms) or less. RoP can destroy the retina, the eye's innermost layer. Mild cases can resolve on their own, but there is no sure way to save vision once aggressive RoP strikes. Laser therapy decreases but doesn't eliminate the chance of blindness, and many babies who don't go blind still suffer severe vision loss.

If the laser therapy fails, scar tissue can cause the retina to detach — but removing that tissue is risky, because a slightly wrong move also can cost vision. Hence the quest to diagnose sooner which babies are getting into trouble, and determine when and how to intervene.

The question is whether either of the tools helps — by diagnosing babies in trouble sooner, or by improving the eye surgery's precision. It is far too soon to know.

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