Which infants should receive an indirect ophthalmoscopy exam for ROP?

• A. All infants 30 weeks gestation or less
• B. All infants 32 weeks gestation or less
• C. All infants 35 weeks gestation or less if they had an unstable medical course
• D. All infants 28 weeks gestation or less

Answer: (A)

Premature infants have incomplete retinal vascularization, which puts them at risk for retinopathy of prematurity. Indirect ophthalmoscopy is used to screen these high-risk babies so any sight-threatening changes can be detected early and treated.

The threshold of 30 weeks gestation or less identifies the group with the highest risk for ROP and is the standard screening criterion used in many guidelines, making them the ones who should receive the exam. The other options set higher gestational ages or add conditions (like instability) that aren’t the primary criteria for initiating initial ROP screening. In practice, birth weight is also a factor, but when focusing on gestational age, 30 weeks or less is the best answer.