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Eye examinations for retinopathy of prematurity: Is this a benign procedure? Problem Statement/Research Questions: Preterm infants undergo routine eye examinations for retinopathy of prematurity (ROP). The exam is a painful, invasive procedure that involves the administration of various ophthalmic drops containing cyclopentolate (anticholinergic, mydriatic); phenylephrine (sympathomimetic, mydriatic); and proparacaine (local anesthetic). This study examined possible changes in the physiologic status of infants who had undergone eye examinations for ROP. The overall purpose was to collect data to inform design of a more comprehensive study. Questions included: What physiologic changes, adverse events or illness events occur the day before the eye examination, and one to two days after the eye examination? Literature Review: Ophthalmic drops may be absorbed directly into the systemic circulation via the cornea, conjunctiva, lacrimal system, and nasal mucosa. Infants are more susceptible to systemic effects because of low weight, immature metabolism, and immature kidneys. Literature review on effects of ophthalmic drops in preterm infants is limited by few studies with small samples. However, feeding intolerance, transient ileus, oxygen desaturation, apnea, hypertension, and seizures have been documented. Acute pain associated with ROP examinations may cause physiologic instability that includes tachycardia and decreased oxygen saturation levels. Pain may also trigger a global stress response in the infant. Methodology: This feasibility study reviewed the medical records of 50 infants who were undergoing their first ROP eye examinations. IRB approval to review medical records was granted. No infants were assigned to the study other than those routinely undergoing the examination according to NICU protocol. Data included demographics, illness severity measured by the Neonatal Therapeutic Interventions Scoring System (NTISS), and any physiologic changes or adverse events noted in medical records. Data analysis & Interpretation: The mean gestational age of the infants at birth was 28.24 weeks, and on the day of the eye examination was 32.34 weeks. Mean infant weight was 1.449 Kg (3.188 lbs). There were 27 male and 23 female infants. There were no significant changes in illness severity (NTISS) scores after the eye examinations. Differences in frequency of adverse events were analyzed using paired data tests and McNemar's test for comparing paired proportions. There were no significant differences in the frequency of bradycardia, low oxygen saturation, and emesis events 24 hours prior to the procedure and in the 24 hours or 24-48 hours following the procedure. Similarly, there was no significant difference in gastric residual before and after the procedure in infants who were tube fed. There was an increased frequency of apnea events in the 24-48 hours following the procedure (p=.04). Infants on a ventilator during any part of the study were not included in the analysis of apnea events. Implications for Nursing Practice and Future Research: Results of this study must be interpreted with caution based on the small sample size. However, the data collected will provide a foundation for measuring outcomes in a clinical trial to determine best nursing practice for supporting preterm infants during eye examinations.