Which of the following is an eye disease affecting prematurely born babies due to excess oxygen therapy?

DSSSB 14 August 2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: DSSSB 14 August 2024

Explanation

Retrolental fibroplasia is the historical term for Retinopathy of Prematurity (ROP), a vasoproliferative disorder of the retina affecting premature infants.
The pathogenesis involves injury to the developing retinal vasculature caused by exposure to high concentrations of oxygen (hyperoxemia) in the extrauterine environment.
Excess oxygen leads to vasoconstriction and damage to retinal vessels, followed by abnormal proliferation of new, fragile vessels that can leak, scar, and cause retinal detachment.

Option A: Nyctalopia, or night blindness, is a symptom of an underlying condition, most commonly Vitamin A deficiency, and is not caused by oxygen therapy.
Option B: Erythroblastosis fetalis is a hemolytic disease of the newborn caused by maternal-fetal blood group incompatibility (e.g., Rh disease), not by oxygen therapy.
Option C: Amblyopia, or 'lazy eye,' is a neurodevelopmental vision disorder where the brain does not properly process signals from one eye. While it can be a long-term complication of severe ROP, it is not the primary disease process caused by oxygen toxicity.

Clinical Relevance

Nursing practice connection: Knowing Complications of oxygen therapy in premature infants helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses in the NICU play a critical role in preventing ROP by meticulously monitoring and titrating oxygen therapy to maintain target saturation levels, avoiding both hypoxia and hyperoxia.
Understanding the risk factors (prematurity, low birth weight, oxygen therapy, sepsis) is essential for identifying at-risk infants who require ophthalmologic screening.
What if? If an infant requires high levels of oxygen for severe respiratory distress syndrome, the priority is survival, but the nursing team must remain vigilant, using the lowest possible FiO₂ to maintain target saturations and advocating for timely ROP screening.

How to Approach the Question

First, break down the question into its key components: 1) an eye disease, 2) affecting premature babies, and 3) caused by excess oxygen therapy.
This is a factual recall question that tests knowledge of neonatal complications.
Evaluate each option against the three key components.
Eliminate options that do not fit the criteria. Erythroblastosis fetalis is a blood disorder. Nyctalopia is related to vitamin deficiency. Amblyopia is a brain-eye coordination issue.
Identify the term that specifically describes a condition of the premature retina caused by oxygen toxicity. Retrolental fibroplasia is the classic term for this condition, now known as Retinopathy of Prematurity (ROP).

Concept Tested & Keywords

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E6 Obstetrics Williams p. 28-48

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1763-1765