OPINION today is divided as to whether the increased frequency of retrolental fibroplasia is due solely to an increase in the number of surviving small premature babies, or whether unknown factors in the babies' external environment are also implicated.
The possibility that frequent ophthalmoscopic examinations of the babies' eyes during the early weeks of life might be responsible has been suggested. The two most likely factors here are (1) exposure of the eyes to the ophthalmoscope light and (2) the action of the mydriatic drops.
The basic pathological change in beginning retrolental fibroplasia is an abnormal proliferation of retinal capillaries.1 When light strikes the retina, complex biochemical changes occur, and its metabolism is altered. It is not inconceivable that such changes in the chemical environment of the developing retinal capillaries may act as a stimulus to their abnormal growth.
Premature exposure of the eyes to light was considered by
LOCKE JC, REESE AB. RETROLENTAL FIBROPLASIAThe Negative Role of Light, Mydriatrics, and the Ophthalmoscopic Examination in Its Etiology. AMA Arch Ophthalmol. 1952;48(1):44-47. doi:10.1001/archopht.1952.00920010047006