Grant: Partnerships for Health System Improvement (PHSI)

Retinopathy of Prematurity (ROP) is a leading cause of preventable blindness and visual impairment in the developed world. It involves the formation of blood vessels in the retina of very premature newborns, leading to bleeding, detachment of the retina and potentially blindness if not treated. Currently in Canada, over four thousand newborns are screened for ROP each year, yet there is no nationally accepted standard as to which children should be included in the screening program or how often they should be screened. The current published Canadian recommendation is to screen all infants under 1501g at birth and/or whose gestation period prior to birth was less than 30 weeks. However, a survey of 16 centres across Canada revealed that at least six different screening protocols are currently being used. Since ROP has severe consequences, it is very important to focus on screening to catch the newborns at risk of blindness before they develop the disease. However, it is not desirable to screen every baby, since there are several drawbacks to ROP screening. ROP screening is expensive to the health care system, painful for the child, stressful for the parents, and time consuming for the examining doctors and nurses. The goal of our study is to formulate and implement the first ever scientifically backed guidelines for ROP screening in Canada. Our recommendations aim to enroll the least number of children into the ROP screening program and minimise the number of examinations for those enrolled, whilst still capturing all those who develop severe disease that will need treatment. This will save the health care system money that can be used for other programs, avoid unnecessary pain and anxiety to newborns and their families, and allow doctors and nurses to make better use of their time.