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Babies born at 37 weeks or less are classified as premature. This means that they had less time than they need to fully develop. Health issues may arise from this shortened time frame and can affect their sight because the eyes go through the final stage of development in the last three months of pregnancy. So, the earlier a baby is delivered, the higher the chances of there being incomplete development of the eyes thus leading to eye problems.

Risk factors for premature birth

These are some factors that can cause premature birth:

  • Mothers under 17 and over 35 years of age
  • Babies of African descent
  • A pregnancy with multiple babies (e.g. twins, triplets)
  • The mother being overweight or underweight
  • Mother having medical conditions like high blood pressure, diabetes, preeclampsia etc.
  • Stress
  • Drug use
  • Smoking and secondhand smoke
  • Alcohol
  • Domestic violence

Possible Eye Problems

Eye defects that can arise from prematurity include:

Retinopathy of prematurity (ROP)

The blood vessels growth can be disrupted when the baby is born prematurely causing abnormal vessels to form in the retina. Most premature babies also need to be on oxygen when born. While this helps their lungs, it disrupts the flow of oxygen to the eyes and prevents proper eye development.

The blood vessels might begin to swell and leak blood and this could cause retinal detachment, leading to vision problems and in some cases, blindness.

Other complications of ROP include strabismus (cross eyes), short-sightedness, long-sightedness, glaucoma, amblyopia (lazy eye)

ROP is prevalent among babies born before 31 weeks or at very low birth weight. Most cases are mild and only a few warrant treatment.

Strabismus or “Cross eyes”

While it can be a complication from ROA, strabismus (cross eyes) is directly connected to low birth weight in babies. These babies have a higher risk of developing strabismus later in life. It often presents in children under the age of 5 and causes a misalignment in one or both eyes. It usually occurs when the cranial nerves responsible for eye movement are weak, or when the eye muscles have a problem.

If not diagnosed or treated early enough it could lead to permanent vision problems.

Strabismus could be horizontal (where one or both eyes turn inwards) or vertical (when one eye is higher or lower than the other normally positioned eye).


As connected to ROP, a retinal detachment which goes undetected could lead to blindness. But there are other causes of blindness in prematurity unrelated to ROP.  In rare cases, the baby could be born without certain parts of the eye such as the iris or even the whole eyeball, which would result in vision loss.



Premature babies are routinely checked in the first three months for sight and hearing challenges. If any sight challenge is noted the appropriate treatment would be administered. Most defects can be treated and others managed properly.

Any changes noted in the eyes particularly in the first year of birth should be mentioned to the doctor managing the case. Contact us for further information and knowledge on how to care for the eyes of premature and low birth weight babies.