Retinopathy of prematurity: it is time to take action

Countries with the highest number of preterm births are India, China, Nigeria, Pakistan and Indonesia. East Asia, South East Asia, and the Pacific are the regions with the highest number of preterm babies who survive, and the highest number who develop visual loss from ROP (Figure 1).2 However, all regions of the world are now affected. For almost 80 years, it has been known that preterm infants can become blind from ROP: it was first described in the United States of America as retrolental fibroplasia. The main risk factors have also been known for a long time. Urgent laser treatment has now been shown to be effective, and screening and treatment programmes have reduced blindness in children from ROP in many high-income countries. So why is ROP an important cause of blindness in children in many lowand middleincome countries? There are four main reasons.