Neonatal medicine now faces a dilemma primarily because advances in this area have reduced the age at which the fetus can survive outside the womb to as little as 23 weeks. In the United States, the approach to management of these infants is that of survival at all costs. This contrasts with the Netherlands, where a more pragmatic line is adopted, based on the high incidence of mental and physical handicap in very premature babies who survive. Paediatric ophthalmologists are faced with the challenge of screening for retinopathy of prematurity (ROP) and providing effective timely treatment to prevent blindness in infants who are frequently very sick and unstable. They must provide follow up for ongoing or anticipated ocular problems. Blindness from ROP is a significant problem, accounting for 8% of children registered in developed countries¹ and 40% in developing countries.²

Knowledge of the pathophysiology of ROP and progress in its treatment has been enormous. The 1984 classification provided an impetus for the CryoRop study. …