As a solicitor specialising in medical negligence, I regularly support families whose premature babies have suffered avoidable harm due to failures in neonatal care. One of the most devastating examples is Retinopathy of Prematurity (ROP) – a condition which, if not identified and treated in time, can lead to permanent sight loss.
In this blog, I explain what ROP is, why timely screening is critical, and how failures to follow national guidelines may amount to medical negligence. I also outline the steps families can take when substandard care results in life-changing injury.
What is Retinopathy of Prematurity?
Retinopathy of Prematurity is a serious eye condition affecting premature babies, particularly those:
- Born before 31 weeks’ gestation; or
- Weighing less than 1.5kg at birth.
In these infants, the retina has not fully developed at birth. Abnormal growth of retinal blood vessels can occur, and without careful monitoring and timely treatment, this can progress to retinal scarring, detachment, and irreversible blindness.
Why ROP screening is essential
National clinical guidelines set out strict screening requirements for babies at risk of ROP. Initial screening should take place:
- Around 4–6 weeks after birth, or at 30 weeks’ gestational age (whichever is later); and
- At regular intervals thereafter, typically every 1–2 weeks, depending on findings.
ROP can progress quickly. Delays, missed appointments, or inadequate examinations can mean the difference between successful treatment and permanent visual impairment.
When screening goes wrong: Breaches of Duty
In many of the cases we investigate, the issue is not that ROP developed, but that opportunities to diagnose and treat it were missed. By way of example, one recent case involved a series of serious failures.
Delayed follow-up screening – Where a screening examination is postponed, national guidance requires it to take place within one week of the planned date. In this case, the infant should have been screened by 8 June, but the examination did not occur until 14 June – a clear departure from accepted standards.
Inadequate documentation – The clinical records from two separate examinations lacked essential detail. Key information such as retinal zone, stage of disease, and assessment of vascular changes was missing. The Trust accepted that the documentation was incomplete, making it impossible to monitor disease progression safely.
Inadequate examination – The findings recorded were inconsistent with the baby’s gestational age of 38 weeks. This raised serious concerns as to whether a proper ROP examination had been carried out at all.
Failure to diagnose ROP – Despite later developing bilateral Stage 5 retinal detachments – the most severe outcome of untreated ROP – the Trust maintained that the retina had previously been “normal”. No clinical explanation was provided for this sudden deterioration, strongly suggesting that ROP was present but missed.
Wrongful discharge from screening – A baby should only be discharged from ROP screening once the retina is fully vascularised and no ROP is present.
The consequences of missed or delayed diagnosis
Without timely screening and treatment, ROP can progress rapidly. In severe cases:
- Abnormal blood vessels cause retinal scarring;
- The retina detaches; and
- Permanent blindness can develop within weeks.
The impact on a child and their family is profound and lifelong.
When poor care amounts to medical negligence
While ROP cannot always be prevented, healthcare providers are required to follow national guidelines and deliver an appropriate standard of care. Medical negligence may arise where:
- Screening is delayed or missed altogether;
- Examinations are inadequate or poorly documented;
- ROP is present but not identified despite clear risk factors;
- Follow-up assessments or referrals are not arranged; or
- Treatment is delayed, allowing the condition to progress to advanced stages.
Where these failures contribute to avoidable visual impairment or blindness, families may be entitled to answers, accountability, and compensation.
If you are concerned about your child’s ROP care
If your child has suffered significant sight loss after being born prematurely and you are concerned that delays or substandard ROP care may have played a role, we are here to help. We can investigate what happened, explain your legal options clearly, and support you through every step of the process. Call us free on 0808 164 0808 today.
