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Population at risk:
Control entails improving neonatal care, the delivery of oxygen, and detecting infants who develop the treatable stages of disease, followed by laser to the peripheral retina. Both these aspects of control are effective at reducing blindness from ROP.
Blindness from ROP can be controlled through 2 broad approaches:
ROP was a major cause of blindness in the USA and Western Europe 50-60 years ago. This occurred because all preterm infants were given 100% oxygen whether they needed it or not. Oxygen is highly toxic to blood vessels, including those in the retina. After the role of oxygen was understood, and it was used less freely, blindness from ROP declined dramatically. Until very recently ROP was, therefore, seen as a condition of the west, and an iaterogenic problem that had been solved. ROP was not included in textbooks for nurses or paediatricians.
Over the last 10-15 years it has become clear that ROP is a major cause of blindness in children in middle-income countries in Latin America, Eastern Europe and the emerging economies of south east Asia (e.g. Vietnam). It is being increasingly reported in China and India. This is happening because these countries are expanding neonatal care, but did not know about ROP.