Clinicians who diagnose retinopathy of prematurity (ROP) find themselves in a nearly perfect storm of converging negative influences. The goal to promptly diagnose prethreshold ROP has resulted in more frequent examinations for some infants. Meanwhile, in many regions of the United States, pediatric ophthalmology is underserved because too few ophthalmology residents choose pediatrics as a subspecialty. Some medium-sized cities must import ROP experts because none are locally available. Screening for ROP can be hazardous to the ophthalmologist. Failure to adequately follow up infants at risk for ROP can result in very large malpractice settlements. Nuances and subtleties that surround the management of adverse-outcome cases are too often debated in court and not in a scientific venue. Reimbursement for examinations barely covers overhead in some situations. Infants' parents may disappear, miss follow-up appointments, and even change the last name of their infant, stressing the efforts of the doctor's office to find and schedule children for ROP examinations after they are discharged from the hospital.
Good WV. Technology and Retinopathy of Prematurity Diagnosis: The New Frontier. Arch Ophthalmol. 2007;125(11):1562–1563. doi:10.1001/archopht.125.11.1562
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