Retinopathy of prematurity (ROP) is a potentially blinding disease that affects premature infants. It occurs when normal blood vessels fail to complete their growth cycle to the edges of the retina. In its advanced stages, the untreated disease can result in permanent and complete blindness.
An ongoing telemedicine project to screen for ROP among premature babies in Gujarat, India, has helped to treat more than 500 eyes, potentially saving the eyesight of infants at risk. The Gujarat Retinopathy of Prematurity (GUJROP) Project provides free treatment to poorer patients.
This project was made possible through a partnership between the non-profit Health and Care Foundation, vitreoretinal surgeon Dr. Alay Banker (who heads its retina division), and the state government. Over the last five years, they worked together to screen and treat over 13,000 premature babies, weighing 2 kg or less. The project was initially started with technical collaboration with renowned eye hospital Narayan Nethralaya in Bangalore, India.
“ROP is emerging as a leading cause of blindness and is seen in larger and heavier babies in India,” said Dr. Banker, who leads GUJROP. The highest number of pre-term births in the world is in India, according to figures from the World Health Organization.
The disease is particularly common among pre-term babies who have been treated with oxygen. Too much of the gas causes blood vessels in the retina to close, affecting their development. Any infant with a birth weight of 2 kg or under is at risk of a loss of vision irrespective of class and socio-economic background of the parents, especially if they are not diagnosed within 30 days.
Dr. Banker noted that there is a huge logistical mismatch between cases to be screened and available ophthalmologists in India. His project aims to provide treatment to pre-term babies within their own city, town or village via telemedicine. The Polio Foundation has installed high-tech equipment in a van to make diagnosis easily available in rural areas. A team comprising a doctor and a technician scans the babies’ eyes and uses a dedicated server to send the scan to the doctor, who then recommends the appropriate treatment.
“To date, we have been able to screen 16,271 babies and saved 565 eyes from blindness, which itself is an achievement in this field,” said Dr. Banker. The ultimate aim is to rid the state of Gujarat of what is, essentially, a curable disease.
These results show that GUJROP telemedicine Public-Private Partnership initiative offers a cost-effective, reliable and accurate screening methodology for identifying infants with ROP without sacrificing quality of care.
“It also did not miss any diseases that required follow-up care nor did any patient have any adverse outcomes,” he said.
The project was also helpful in increasing awareness of ROP among patients and pediatricians, and could be very effective in screening for ROP in resource-strapped areas.
A partner of the project, the non-profit Health and Care Foundation, in Ahmedabad, India, has been providing free medical care to underprivileged patients for more than 28 years through prevention, disease control, surgeries and better understanding of their health issues. The organization first started by providing corrective surgeries for children afflicted with polio, with the aim of helping to eradicate polio in the country in the near future. Slowly but steadily, it began spreading its wings to other streams to help more people.
To date, it has units for pediatric orthopedics, spinal surgeries, diabetic retinopathy, retinal surgery, pediatric and adult cataract, squints, corneal grafting, glaucoma surgery, mammography and cervical cancer unit, rehabilitation of children with cerebral palsy, pain management, dialysis and diabetic foot conditions. They also provide artificial limbs for needy patients.
