Table 5: Follow-up Schedule

Timing of Follow-up Examinations Indication

1 week or less • Stage 1 or 2: Zone I

• Stage 3: Zone II

1 to 2 weeks • Immature vascularization: Zone I—no ROP

• Stage 2: Zone II

2 weeks • Stage 1: Zone II

• Regressing: Zone II

2 to 3 weeks • Immature vascularization: Zone II—no ROP

• Stage 1 or 2: Zone III
• Regressing: Zone III

No further examinations required
• Zone III vascularization attained without previous ROP
• Full retinal vascularization
• Postmenstrual age of 45 weeks and no pre-threshold disease or
worse ROP is present (Pre-threshold defined as: Stage 3 ROP in
Zone II, any ROP in Zone I)
• ROP is definitely regressing, based on at least two examinations.

3.5. Protocol for Screening 3.5.2. Personnel for Screening Examinations

Examinations using indirect ophthalmoscopy

3.5.1. Setting for Screening Examinations
The ideal setting for screening is under a radiant warmer in the
NICU, conducted by ROP trained doctor/ophthalmologist
under the guidance of a neonatologist and anaesthesiologist
with assistance from nursing staff. Discharged and stable
babies may be screened in the ophthalmology unit/clinic
or in the NICU at the time of the neonatal follow up to
reduce the number of follow up appointments parents have
to make.
Place should be warm enough and clean. If babies are being
screen by a ROP specialist at a Ophthalmology unit, there
should be arrangement for basic resuscitation equipment
and if possible screening should be done with support of
an anesthesiologist and/or a neonatologist. Babies who are
admitted at NICU and critically ill can be screened without
any criteria (mentioned above) obtaining informed written
consent from the legal guardians and such babies must
be screened at NICU in presence of neonatologist and
monitored using a pulse oximeter.
A team should consist of ROP trained ophthalmologist(s)
along with a doctor and nurse from the NICU/SCANU.
Medical personnel sufficiently trained in ROP screening
should perform the examination or an Optometrist under
the guidance of ROP trained Ophthalmologist can perform
quality screening with the assistance of SCANU/NICU
team. Preferably the team should comprise an trained
ophthalmologist, medical officer and a NICU/SCANU nurse.
The ophthalmologist has to be nominated to visit NICU/
SCANU at least once a week. One medical officer and one
nurse from the NICU/SCANU have to be made accountable
for screening of ROP (registration, data entry/recording and
follow up etc.) . The Optometrist under the supervision of
a trained ophthalmologist will schedule / plan for visiting
NICU/SCANU and will ensure screening and follow up of
the at-risk children.

Details of the equipment, drugs and instruments are

provided in the section 3.5.3.

Page 15