CURRENT PROBLEMS IN THE MANAGEMENT OF ROP

Guidelines for screening for retinopathy of prematurity (ROP) and indi cations for treatment are well established, but implementation of scre ening and delivery of treatment may be problematical. We have performe d a national survey of 118 specialised units dealing with at risk neon ates to audit current practice in Britain and to identify practical pr oblems with screening and with treatment. A screening policy for neona tes at risk is in practice at 97% of units, performed by consultant op hthalmologists in 86% of centres. Units referred to specialised treatm ent centres in 23% of cases. An average of 54 infants at risk of ROP w ere screened by each of 118 units throughout Britain in 1993, and appr oximately 3% of these infants underwent treatment for ROP. Cryotherapy was used for treatment in 85% of units, laser photocoagulation in 51% and both treatment modalities were used in 36% of units. Less than 1/ 4 of the neontologists polled were of the opinion that they should be trained to screen for ROP themselves. These results show that the scre ening guidelines have been successfully implemented in Britain, but de monstrate a wide variation in practice. Problems with screening and tr eatment are discussed.