Analysis of Universal Eye Screening in

3,573 Healthy Full-term Neonates

Li Li-Hong1, Zhao Jun-Yang2, Li Na1
Maternal and Childrens Hospital, Kunming 650031, Yunnan;
Beijing Tongren Ophthalmic Center, Capital University of Medical Sciences. Beijing 100730, China.
Corresponding Author: Li Li-Hong (Email: yllilly@163.com Tel:18908851052)

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[Abstract] Objective:
To establish the effectiveness of a newborn eye screening program for detecting ocular pathology in the healthy, full-term
neonate. It is anticipated that early detection may lead to treatments that can prevent blindness and visual disability.

Methods:

Neonates born in our hospital were screened within seven days after birth using flashlight, retinoscope, hand-held slit lamp
microscope and wide-angle digital retinal image acquisition system (RetCam II). External eye, pupillary light reflex, red
reflex, the opacity of refractive media, anterior segment, and posterior segment were examined.

Results:

A total of 3,573 healthy neonates were enrolled in the screening program, with detection of 848 abnormal cases (23.73%),
including 769 retinal hemorrhage (21.52%). There were 215 cases of significant retinal hemorrhage (III degree), representing 6.02% of the total. In addition, 67 cases (1.88%) involved macula hemorrhage. The other 107 cases (2.99%) included:
subconjunctival hemorrhage, lacrimal duct obstruction, congenital microphthalmos, congenital corneal leucoma, posterior
synechia, persistent pupillary membrane, congenital cataract, enlarged C/D ratio, retinoblastoma, optic nerve defects, abnormal distribution of macular pigment, peripheral retinopathy, exudative retinopathy, and albino-like fundus changes.

Conclusion:

Screening of all healthy newborns leads to detection of a significant number of ocular pathologies. RetCam photodocumentation is a safe, convenient, fast, and objective technique to screen newborns, leading to timely treatment and detailed followup observation of lesions.
Key words: healthy neonates; screening for eye disease; RetCam

Fig. 1: Right eye, degree III retina hemorrhage extended to macula. Left eye, degree II retina hemorrhage.
Follow up exam three weeks later, right eye macula hemorrhage not absorbed; left eye retina hemorrhage
absorbed completely.

Fig. 2: Above graph: three days after birth during a routine screening, a retinoblastoma
was found in both eyes
Lower graph: A follow up exam using RetCam one month after birth, with a laser treatment 8 weeks after birth

Clarity Medical Systems, Inc. is the manufacturer of RetCam Ophthalmic Imaging Systems. Clarity had no knowledge, input, editorial review, etc. over this article. Clarity is unaware of any risk or safety concern relative to the use of
RetCam Ophthalmic Imaging systems in any use of this device reference in this article. The RetCam Systems are FDA
cleared for the following indications:
General ophthalmic imaging including retinal, corneal and external imaging;
Photodocumentation of pediatric ocular diseases including retinopathy of prematurity (ROP);
Screening for Type 2 pre-threshold retinopathy of prematurity (ROP) (zone 1, stage 1 or 2, without plus disease, or zone 2, stage 3, without plus disease) or treatment-requiring ROP, defined as Type 1 ROP (zone 1,
any stage, with plus disease; zone 1, stage 3 without plus disease; or zone 2, stage 2 or 3, with plus disease)
or threshold ROP (at least 5 contiguous or 8 non-contiguous clock hours of stage 3 in zone 1 or 2, with plus
disease)* in 35-37 week postmenstrual infants.
* References
1. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity;
preliminary results. Archives of Ophthalmology 1988; 106(4):471-479.
2. Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of
prematurity: results of the Early Treatment for Retinopathy of Prematurity Randomized Trial. Archives of Ophthalmology 2003;
121(12):1684-1694.