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Plus disease is the second stage of ROP,
signifying that the disease is active and likely to
progress. The presence of indicators of plus disease is what physicians use to determine whether
or not to start laser treatment. Symptoms of plus
disease include enlarged vessels, overly twisted
or "tortuous" vessels, and/or excessively dilated
vessels (Awad, Ells, Solarte, & Wilson, 2010).
Laser treatment on an infant requires some
level of sedation, depending on the available facilities (operating room or doctor's office). The
physician can treat both eyes in one session and
the infant can go home after treatment. Followup examinations should occur weekly and if another treatment is required, it should be done
within 10-14 days after the initial treatment. Another treatment would be necessary if
the vessels continue to grow, indicating a continuation of the progression of ROP (Agarwal,
Azad, Chandra, Chawla, Deorari, & Paul, 2012).
If treatment to prevent the proliferation of
vessels fails or is not provided in a timely manner,
the retina can be damaged or become detached. Repairs to the retina can be done in various ways. One way to repair a detached retina is
scleral buckling. In this procedure, a flexible
band, usually made of silicone, is placed around
the outside of the eyeball causing the eye to
buckle in, pressing the retina back against the
choroid layer, restoring blood flow and some vision. The following illustration from the Vanderbilt
Children's Hospital website (Vanderbilt Children's
Hospital, 2009) diagrams the placement and action of a scleral buckle:
Another treatment for detached retina is vitrectomy. This lengthy procedure involves removing
all of the vitreous from the eye in order to remove
scar tissue pulling at the retina causing detachment. The vitreous is then replaced with a saline
solution (Vanderbilt Children's Hospital, 2009).
