Retinopathy of prematurity

That retinopathy of prematurity (ROP) is occurring with increasing frequency in transitional economies is no longer debatable. Recognising this fact, the World Health Organization has identified ROP as a leading cause of vision impairment in children in the developing world.1 Others have identified ROP as an important, increasingly common, and potentially treatable condition in emerging economies.2,3 No doubt, improvements in neonatal care in various regions of the world are allowing smaller infants to survive. The question is, what constitutes a low birthweight infant in an emerging economy? To answer this question requires information on the demographics of ROP in these regions.

But demographics of ROP in transitional economies are hard to ascertain. Without this knowledge, it will be difficult to identify those infants who should be screened and treated. Reports of the disease occurring in larger than expected birthweight infants, in increasing frequency, in more mature infants, are alarming. These reports are well designed and carefully conducted but they are hampered by the chaos that exists in medical care delivery in the developing world. This must be especially true when premature infants are considered. Nothing should be left to chance in evaluating premature infant disease in the developing world, and no demographic data should be considered entirely reliable unless directly …