The Indian Retinopathy of Prematurity (IROP) Society was established in July 2016 out of a felt need. The menace of retinopathy of prematurity (ROP) blindness had reached alarming proportions in the nation. The number of preterms born had crossed 3.5 million annually, more than any other nation in the world. Improved neonatal survival, mushrooming of over 700 “special neonatal care units (SNCUs)” in nearly all district headquarters, a very low prevalence of ROP screening programs and only a handful of “ROP specialists” are some of the myriad reasons the country was facing the epidemic of the disease.[1] Founded on the vision of “Bridging barriers and breaking boundaries for ROP care”, it laid down short, intermediate, and long-term goals for itself.[2]
After 3 years, the membership has increased steadily from 113 initial members to 215 currently. Only ophthalmologists directly involved in either screening or treatment are currently allowed membership. With over 20,000 ophthalmologist members of the All India Ophthalmological Society, nearly 2000 Vitreo-Retinal Society of India members, it appears that less than 1% of ophthalmologists in the country are involved directly in ROP care.
More grim than the shortage of experts are the unmet challenges while facing the situation 1) lack of a uniform pattern of ROP screening, 2) lack of collaboration between the neonatologists, pediatricians, and ophthalmologists, 3) lack of collaboration between the private and public sector, 4) unsolved medicolegal aspects relating to timely screening, appropriate follow-up and treatment, 5) lack of uniform guidelines for intravitreal anti vascular endothelial growth factor injections, and 6) lack of a roadmap and resources for long-term follow-up of these ROP graduates.
This special edition of the Indian Journal of Ophthalmology puts together efforts to address few of these challenges. From community-based data[3] to newer methods of screening,[4] the manuscripts make a significant contribution to bringing evidence to the practice of ROP care.
As the iROP society continues to impact work in India, it has expanded its influence in initiating the Asia Retinopathy of Prematurity Working Group in March 2019, with the aim of sharing experiences, collaborating resources, and unifying practice patterns. The operational guidelines for ROP screening that the National Task Force for ROP in India released in 2018 has already become popular in other nations in the Indian subcontinent and beyond.[5] With common disease demographics and lack of resources, we must break barriers and cross borders to effectively tackle the scourge of ROP.
References
- 1.Vinekar A, Dogra M, Azad RV, Gilbert C, Gopal L, Trese M. The changing scenario of retinopathy of prematurity in middle and low income countries: Unique solutions for unique problems. Indian J Ophthalmol. 2019;67:717–9. doi: 10.4103/ijo.IJO_496_19. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Vinekar A, Azad R, Dogra MR, Narendran V, Jalali S, Bende P. The Indian retinopathy of prematurity society: A baby step towards tackling the retinopathy of prematurity epidemic in India. Ann Eye Sci. 2017;2:27. [Google Scholar]
- 3.Sai Kiranmayee P, Kalluri V. India to gear up to the challenge of “third epidemic” of retinopathy of prematurity in the world. Indian J Ophthalmol. 2019;67:726–31. doi: 10.4103/ijo.IJO_700_18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Goyal A, Gopalakrishnan M, Anantharaman G, Chandrashekharan DP, Thachil T, Sharma A. Smartphone guided wide-field imaging for retinopathy of prematurity in neonatal intensive care unit – a Smart ROP (SROP) initiative. Indian J Ophthalmol. 2019;67:840–5. doi: 10.4103/ijo.IJO_1177_18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. [Last accessed on 2019 May 14]. Available from: https://phfi.org/wp-content/uploads/2019/05/2018-ROP-operational-guidelines.pdf .