Florida Retinopathy Of Prematurity (ROP) Lawyer
As the parent of a child impacted by Retinopathy of Prematurity (ROP), you are likely consumed with understanding the causes, treatments and long-term outlook for babies rendered blind or severely sight-impaired by ROP. You may also be rightfully concerned with how your family will cope with the financial aspect of raising a child with special needs. What many parents don’t realize is that medical negligence may have caused their child’s vision problems and that compensation may be recovered to alleviate some of the future financial challenges their child will face. At Freidin Brown, P.A., our Florida ROP lawyers are experts at identifying when medical malpractice has caused a lifelong injury to a child, as well as recovering much-needed compensation to deal with the challenges your child will face and obtain the best medical outcome and quality of life your child can achieve.
What Is Retinopathy of Prematurity (ROP)?
Retinopathy of Prematurity: A Cause of Infant Blindness
Retinopathy of Prematurity (ROP)-sometimes called retrolental fibroplasia-is one of the most prevalent causes of childhood vision loss. It affects premature infants and, without proper treatment, it can lead to blindness or severe, permanent sight problems. Retinopathy refers to improper development of the blood vessels at the back of the eye. These blood vessels are essential to the nourishment and proper function of the retina, which is the light-sensitive tissue lining the back of the eye. For proper vision, the retina must be intact and able to send information to the brain via the optic nerve. Retinal detachment is a common cause of blindness-and the ultimate outcome in the most severe, untreated cases of ROP.
Premature, Low-Weight Babies Are the Victims of ROP
Retinopathy of prematurity (ROP) is so named because it is a disease unique to premature babies-most commonly, those born before about 32 weeks gestation and weighing less than three pounds. It occurs when the blood vessels grow toward the center of the eye rather than lining the retinal bed, as they do in normal eye development. If not properly diagnosed and treated, ROP can lead to retinal scarring, retinal detachment, and blindness. Our Florida ROP lawyers have learned that a properly trained, diligent specialist will know the five stages of ROP, which have a direct bearing on whether treatment is necessary.
The difference in outcome often depends primarily on:
- Identification of ROP risk by a pediatrician or neonatologist
- Proper, frequent monitoring of the premature baby by an ophthalmologist with ROP training
According to the website of the National Eye Institute (NEI), one of our federal government’s National Institutes of Health, of about 14,000 to 16,000 infants affected by ROP each year, several hundred are rendered legally blind. This does not have to be the result, especially given today’s availability of effective ROP treatments including laser therapy.
ROP Facts & Statistics
Retinopathy of Prematurity: A Serious but Treatable Disease
Babies born very prematurely-earlier than about 32 to 34 weeks-require special medical attention and care in almost every respect. Not everyone is aware that the serious eye disease called Retinopathy of Prematurity (ROP) is also among these medical concerns.
Here are some basic facts and observations on ROP:
- Retinopathy of prematurity was first identified and described in the early 1940s, and it was originally called retrolental fibroplasia.
- Each year in the United States, approximately 14,000 to 16,000 premature infants are affected by ROP. As many as 600 of these children may become legally blind.
- The great majority of babies who develop ROP improve without treatment, but more severe cases have serious consequences including retinal detachment and blindness.
- Proper screening and diagnosis includes classifying each ROP case according to five stages of severity.
- Generally speaking, experts agree that the lower a premature baby’s birth weight, the greater that child’s risk for developing ROP. Any child weighing less than about three pounds at birth should be evaluated and monitored.
- The greatest period of risk for development of ROP is believed to be from 30 to 42 weeks after conception.
- An infant’s risk for developing ROP may be increased by a range of factors, including oxygen administration or other serious illnesses.
- Once ROP is identified in a premature infant, frequent and diligent monitoring by a qualified ophthalmologist is usually necessary.
- The exact causes of ROP have not been pinpointed. However, medical research is active and ongoing, and newer treatments including laser therapy have proven effective in many cases.
- Juries in various U.S. locations have returned sizeable verdicts to compensate medical wrongdoing in ROP cases. In a 2008 Lee County, Florida, case, lawyers at Freidin Brown, P.A., along with co-counsel, obtained a $38 million award for twin boys and their parents.
Understanding the Causes of Retinopathy of Prematurity
Infants born prematurely are at a significantly greater risk of developing Retinopathy of Prematurity (ROP). In fact, approximately 80 percent of pre-term babies develop ROP and as many as 600 of these infants will become blind. Parents in this situation undoubtedly have many questions about ROP, including what they can do for their child, what caused the condition, and whether the condition could have been prevented. Our Florida ROP lawyers at Freidin Brown, P.A. can help you obtain answers to these important questions.
At present, there is no definitive answer as to what specifically causes retinopathy of prematurity (ROP). However, there is a strong correlation between supplemental oxygen treatments administered to premature babies and ROP.
Risk Factors for Premature Babies
Babies born prematurely are at a significantly higher risk for a number of health complications than full-term babies. If you or a loved one recently gave birth to a pre-term baby, you may be overwhelmed by existing medical complications, as well as the number of potential medical complications that your child could experience. One significant risk for pre-term babies is retinopathy of prematurity (ROP)-which can lead to vision impairment and even blindness. All pre-term babies should be proactively screened for ROP.
ROP Risk Factors
While prematurity is not the only risk factor considered by doctors on whether to screen for ROP, it is one of the most prevalent indications that a child will develop ROP-approximately 80 percent of babies born prematurely will develop ROP.
Other risk factors that doctors consider include:
- Supplemental oxygen treatments
- Race (Caucasian babies have a higher risk than other races)
- Twins, triplets or multiple births
- Significantly low birth weight (under 1000 grams or 2-3 pounds)
- Respiratory distress
Advocate for Proper Care
Diligent medical professionals will screen babies with known risk factors. However, the timing and frequency of these screenings are critical. If your child has not yet been screened or has not been screened frequently enough-at least two to three times per week-request a screening by a specialized ophthalmologist and be certain to follow up on this care. Learn what else a parent can do.
Understanding How ROP Occurs
While the eye starts to develop as early as 16 weeks into pregnancy, the blood vessels at this stage are relatively undeveloped. Throughout gestation, these blood vessels gradually start to move toward the retina. The most critical stage of growth for these vessels occurs in the last weeks of pregnancy and the first weeks after birth. However, if a baby is born prematurely, the flow of oxygen and nutrients stops and the blood vessels may not be able to grow completely to the retina.
Oxygen, Immaturity, & ROP
- Oxygen treatments: In the past, oxygen treatments were administered to premature babies to help them survive. However, this practice has slowed somewhat as research suggested a correlation between supplemental oxygen treatments and the onset of ROP. In essence, it has been argued that supplemental oxygen treatments can cause abnormal blood vessel growth.Nevertheless, the practice of administering oxygen treatments to premature babies is often inescapable due to the many other health issues that benefit from such treatment.
- Lack of nourishment: Because oxygen and nourishment cannot reach the retinal blood vessels, nourishment may come from other areas of the eye. This can cause abnormal blood vessel growth.
- Bleeding and scarring: Abnormal blood vessels are weak and can bleed. Bleeding causes scarring. As the scars heal and shrink, they may pull at the edges of the retina – this can lead to retina detachment which causes blindness.
Stages of ROP
Understanding Mild & Severe Retinopathy
Proper monitoring and timely identification are the most important factors in preventing premature infant blindness due to Retinopathy of Prematurity (ROP). Current medical knowledge on ROP includes the identification of the five stages of the disease. Understanding these stages is important for a Florida medical malpractice lawyer to uncover the facts about how this dangerous, potentially vision-destroying condition is misdiagnosed or left undiagnosed by medical professionals.
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Mild to Moderate ROP: Stages 1, 2 and 3
In stage 1, an ophthalmologist may detect some abnormal blood vessel growth. We have heard this described as “seeing a line” that indicates normal blood vessels are not growing toward the edges of the retina. In stage 2, this line becomes more pronounced. Monitoring is important, but treatment may not be necessary in ROP cases that do not progress beyond this stage.
In stage 3 ROP, the physician can see that blood vessels are growing abnormally, toward the center of the eye rather than evenly across the surface. We have heard this described as the appearance of a “ridge.” If the disease continues to progress, retinal detachment can result. Treatment—typically by laser therapy or cryotherapy—may be required to prevent these tragic outcomes.
Severe ROP and Retinal Detachment: Stages 4 and 5
Stage 4 is defined by a retina that has become partially detached due to the “traction,” or pulling pressure, on it. The macula—the most sensitive part of the retina—may or may not have detached at this point, a distinction sometimes described as stage “4a” versus “4b.”
Stage 5 ROP is complete retinal detachment. Leaking blood vessels and scarring have pulled the retina completely away from the rear eye wall and optic nerve. A lack of treatment at this point means severe vision loss or blindness. Reattachment surgery may be possible, but is not always recommended and not always successful.
Understanding ROP History
Vision-Destroying Disease Identified in 1940s Still a Concern Today
Retinopathy of Prematurity (ROP) was first identified in the early 1940s. For some time, it was called Retrolental Fibroplasia (RLF). In the early 1950s, physicians and researchers identified a connection to the high levels of oxygen administered to premature infants. Too much oxygen produced abnormal blood cell development that sometimes led to retinal detachment and blindness. At that time, many believed that reducing levels of oxygen given to premature babies would permanently eliminate ROP.
Excessive Oxygen Proved to Be Just One Cause of ROP
Although ROP was not prevalent in the 1960s, it became a significant concern again in the 1970s. Advances in neonatology and medical technology had begun increasing survival rates for infants of very low birth weight—the babies most susceptible to ROP. Clinical trials demonstrated that oxygen therapy was not to be the sole cause of this serious disease. Today, risk factors are better understood, but the causes of ROP have still not been fully isolated.
Progress in Understanding, Diagnosis, & Treatment
A large-scale analysis known as the CRYO-ROP study was carried out in numerous U.S. hospitals in the 1980s. Many facts and statistics we rely upon today have origins in this study, which investigated the effectiveness of cryotherapy as a treatment for ROP. This procedure involves applying a probe to the eye wall to freeze portions of the retinal surface and stop abnormal cell growth. Cryotherapy was found to be effective for many patients when intervention was timely. Today, laser therapy has become the preferred treatment in part because it allows more precise treatment of the retina.
Today, most high-risk hospitals and neonatology facilities are equipped to screen infants for ROP. The development of a standard for assessing the disease according to five stages has helped promote advancements in ROP research. Failure to diagnose the disease has become unacceptable under most circumstances.
What a Parent Can Do
Florida ROP Lawyers for Parents of Premature Babies
Parents of premature infants can spend months at the hospital watching over a baby and his or her care. Multiple doctors of different specialties are more than likely treating your infant during this time and providing you with a surplus of medical information. Our Florida ROP lawyers offer insightful advice that can help you make sense of this vast medical information and make a difference in the quality of care your child receives.
Pre-Term Birth & Infant Blindness
Pre-term babies are at a high risk for multiple health complications. One of these complications is the development of Retinopathy of Prematurity (ROP) which can lead to vision loss or even blindness if not properly monitored or treated.
For parents in this situation, we recommend the following tips:
- Make sure your infant is screened – If your child was born prematurely, they more than likely require diligent screening for ROP. Be certain to ask if your child has been screened, and if so, be certain to discover when, by whom and the results.
- If your child has not been screened for ROP – Request an immediate screening. Time is of the essence. Ask when the appointment is (many times, the doctor will come while the parents are away) and be there.
- Talk to the ophthalmologist – By attending each screening, you have an opportunity to speak directly with the physician. Ask what he/she saw, if treatments are necessary at this stage, when the next screening will be, etc. If you cannot be at the appointment, call the physician and ask the same questions. This kind of diligence can make a significant difference.
- Make certain screenings are frequent – ROP can develop and advance very quickly. A single screening each week could cause doctors to miss advancement of the condition. For some children, two to three screenings per week will be necessary.
Most doctors in the Neonatal Intensive Care Unit (NICU) will provide your baby with the level of care that is expected and required. However, vigilance on the part of the parent can help assure that every precaution is taken. In the most unfortunate cases, doctors fail to properly identify a baby as at risk for ROP, fail to properly screen/monitor, and the condition quickly advances, causing retinal detachment and blindness. In these tragic circumstances, the attending doctors can and should be held fully liable for their medical negligence.
ROP and Medical Malpractice
ROP is a condition that occurs in certain premature, low-birth babies where the blood vessels in the eye do not grow as they should. The consequence of ROP is severely-limited sight vision or blindness. ROP requires proper identification of risk by a pediatrician or neonatologist, and it requires frequent proper monitoring by an ophthalmologist with training on ROP. The tragic effects of retinal scarring, retinal detachment or blindness do not have to occur with proper diagnosis, monitoring and medical care. When misdiagnosis or other mistakes cause serious injuries that could have been prevented, the medical malpractice and birth injury lawyers at Freidin Brown, P.A. can help. Learn more about ROP below, and contact our offices in Florida and Fort Myers for a free, confidential consultation.
Retinopathy of Prematurity Research
Research on Retinopathy of Prematurity (ROP) is active and ongoing. One important conclusion seems no longer to be a subject of debate: The key to saving the sight of many premature babies is timely diagnosis of ROP in its early stages, accompanied by proper treatment once the disease is identified.
Ongoing Efforts Address Retinopathy of Prematurity
Ophthalmologists and referring physicians continue to be challenged by factors such as the unpredictability of when the disease develops and the ideal examination regimen for infants who show mild symptoms. Emerging diagnostic tools and newer treatments must be studied for their effectiveness, side effects and complications.
ROP-related research in recent years has focused on subjects including:
- The effectiveness of new screening and examination techniques, such as wide-angle retinal imaging and telemedicine
- ROP risk factors for different ethnic and national groups
- Efforts to further define and understand the progression of ROP through its five known stages
- Continued investigation into the effectiveness and long-term effects of treatments such as cryotherapy and laser therapy
- Risk factors for different ethnic and national groups
- Attempts to lower costs and make diagnosis and treatment more available
- Overall studies of quality of life for low-birth-weight babies as they advance through childhood and into adulthood
Retinopathy of Prematurity Treatments
The most important things to know about today’s Retinopathy of Prematurity treatment options are that they are widely available and are often effective in prevention of blindness for premature infants. Before treatment comes monitoring and diagnosis, however, and this is critical for at-risk babies. For those seeking to prevent ROP from progressing, it is critical to insist on the baby being examined by a specialist. In order to intervene in a timely manner with an appropriate ROP treatment, the ophthalmologist must know the stages of ROP.
Infants with mild to moderate ROP may not require treatment. If abnormal blood vessel growth that can cause retinal detachment is severe, however, the right treatment is often essential to saving the baby’s sight. When ROP treatment is necessary, however, the window for timely intervention is usually small.
Laser Therapy & Cryotherapy
The most effective ROP treatment today is widely held to be laser therapy. This is now considered superior-because of its greater precision-to a treatment used for decades called cryotherapy.
Both these ROP treatments are targeted at removing the edges of the retina-essentially by burning them with a laser, or by freezing them with a probe. Their goal is to stop progress of abnormal blood vessel growth and relieve the pressure that leads to retinal detachment. Although some peripheral vision is lost, these treatments-if done in time-can save an infant’s sight.
Treatments After Retinal Detachment
Once ROP reaches stage 4 or stage 5, the retina is partially or completely detached. Surgery in the form of scleral buckling or vitrectomy is sometimes performed, with mixed results. However, the more researchers learn about ROP, the clearer it becomes that timely identification and treatment by stage 3 offers the best chance of preventing baby blindness.
Contact Experienced Florida ROP Lawyers Today
If your child suffers from retinopathy of prematurity in Florida, call Freidin Brown, P.A. at 866-716-7292 for a free consultation with experienced, compassionate and effective Florida medical malpractice and birth injury lawyers. We’ll help you and your child get the care and compensation you need to deal with the effects of ROP; if we can’t help or recover compensation for you, there’s never any fee.