As part of their work as pediatric ophthalmologists at UW Health, Alexander Miranda, MD, Yasmin Bradfield, MD and Melanie Schmitt, MD see and treat infants in two Madison, Wisconsin neonatal intensive care units. There, they provide crucial screening and treatment for Retinopathy of Prematurity (ROP), a condition that affects some premature and low birth weight babies.
ROP happens when abnormal blood vessels grow in the retina, the light- sensitive layer of tissue coating the back wall of the eye. While some babies with ROP have mild cases that can improve on their own, others require treatment to protect their vision and potentially prevent blindness.
Because ROP often has no signs or symptoms, routine screening is necessary for at-risk infants.
“Premature and low weight infants need screenings to make sure their retinas are forming properly,” explained Dr. Schmitt. “If a baby’s retinas are not forming correctly, there can be devastating results. They can develop retinal detachments and hemorrhages, and they can even go permanently blind. It is important to catch things early and intervene immediately.”
Screening requires a dilated retinal exam within a few weeks of birth. It is traditionally performed by an on-site ophthalmologist or trained retinal photographers, utilizing specialized cameras, which is then reviewed by an ophthalmologist.
“Unfortunately, there is a shortage of pediatric ophthalmologists qualified to perform the exam and screen these at-risk babies,” said Dr. Miranda, chief of the pediatric ophthalmology and adult strabismus service in the University of Wisconsin Department of Ophthalmology and Visual Sciences. “We didn’t want this shortage to become a barrier to patient access and were motivated to find a solution.”
The result was the Teleophthalmology for Retinopathy of Prematurity Program. Spearheaded by Dr. Miranda, the new telemedicine program allows the team of pediatric ophthalmologists in the University of Wisconsin Department of Ophthalmology and Visual Sciences to screen for ROP from their offices, using digital images taken with specialized photographic equipment.
“Research has shown that digital retinal photos are highly accurate for detecting clinically-significant ROP, and telemedicine-based retinal photography is comparable to in-person examinations,” Dr. Bradfield adds. “And because the ophthalmologists do not have to be on- site, more are available to interpret the images and make diagnostic decisions. It is playing a crucial role in addressing the current workforce need.”
Funding was secured to place the necessary photographic equipment at a Madison, Wisconsin hospital. The program started this summer with training photographers working alongside a pediatric ophthalmologist. The screening and evaluation process became fully operational in the fall of 2024.
“Once fully operational, the program should greatly improve patient access to this critical care,” Dr. Miranda said. “In addition, this project has the potential to expand coverage to other neonatal intensive care units in Wisconsin and other states.”