Tommy's PregnancyHub

Your premature baby's vision and hearing

Some premature babies are more likely to develop problems with their eyesight or hearing. Your baby will be checked to pick up any problems at an early stage.

 

Retinopathy of prematurity (ROP)

The retina is the lining at the back of the eye that detects light, allowing us to see. The blood vessels in the retina aren’t fully developed in very premature babies. After birth, these blood vessels can sometimes start developing abnormally, leading to sight problems. This is called retinopathy of prematurity (ROP).

What causes ROP?

It’s not clear what causes ROP, but high levels of oxygen may increase the risk of it developing. Premature babies need oxygen to grow outside the womb so the healthcare team will carefully balance the amount of oxygen they give your baby. 

Is my baby at risk of ROP?

If your baby was born before 32 weeks or weighed 1.5kg or less at birth, they are at risk of ROP and will be offered screening. The screening examination involves looking at the back of your baby’s eyes.  

Your baby will have their first examination when they’re 4–6 weeks old. Most babies will need at least 2 examinations.  The healthcare team will tell you what is involved and how you can help comfort your baby during these examinations.

The Royal College of Paediatrics and Child Health (RCPCH) has more information about screening for ROP

How is ROP treated?

Most cases of ROP are mild and don’t need treatment. 

A small number of babies will have severe ROP, which can lead to sight damage if its not treated. Your baby may have 1 or more treatments with either an injected medication, laser therapy or cryotherapy (freezing therapy). The healthcare team will discuss the most appropriate option for your baby with you.

Your baby will need regular eye checks for a few years so that any sight problems are picked up quickly.  

The Royal College of Paediatrics and Child Health (RCPCH) has more information about treatment for ROP

Hearing problems and premature birth

Hearing loss is more common in premature babies, but the risk is still low.   

What causes hearing problems?

There are many possible causes of hearing loss, such as genetics, infection or complications during birth. In premature babies, the ears may still be developing when they’re born, which makes them sensitive to noise. 

How are hearing problems diagnosed?

All babies are screened for hearing problems. Premature babies are tested after 34 weeks, when they’re well enough. The healthcare team will tell you when your baby’s hearing will be checked.  

If the results aren’t clear, they may be referred to a hearing specialist (audiologist) for further tests. This doesn’t always mean that your baby has a hearing problem. 

If your baby does have hearing loss, the audiologist will give you information and support. NHS has more about screening and hearing loss.

What does this mean for my baby?

Don’t be afraid to ask the staff any questions you need to that will help you understand what is happening. This will help you make informed decisions about your baby’s care. Be involved with as much, or as little, as you feel comfortable with.
Find out more about your role in caring for your premature baby.

It can be very stressful if your newborn has vision and hearing problems. Find out more about coping with this
 

Pammi M (2020) Premature newborn care. BMJ Best Practice. https://bestpractice.bmj.com/topics/en-gb/671/pdf/671/Premature%20newborn%20care.pdf

Royal College of Paediatrics and Child Health, Royal College of Ophthalmologists British Association of Perinatal Medicine & BLISS (2008) Guideline for the Screening and Treatment of Retinopathy of Prematurity https://www.rcpch.ac.uk/sites/default/files/2018-03/guideline_for_the_screening_and_treatment_of_retinopathy_of_prematurity_2008-05.pdf
  
Sankar MJeeva, et al. Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity. Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD009734. DOI: 10.1002/14651858.CD009734.pub3

NICE (2017) Developmental follow-up of children and young people born preterm. NICE guideline 72. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng72/chapter/Recommendations

PHE (2017) Babies in special care units: screening tests for your baby. Public Health England. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/712824/NICU1_Babies_in_special_care_units_Screening_tests_for_you_and_your_baby.pdf
 
HE (2016, updated 2020). Newborn hearing screening programme (NHSP) operational guidance. Public Health England. https://www.gov.uk/government/publications/newborn-hearing-screening-programme-nhsp-operational-guidance