Premature babies in Pakistan face high risk of blindness due to ROP screening gaps

Islamabad: Premature babies in Pakistan are losing their eyesight at rates well above global averages as retinopathy of prematurity (ROP), a treatable eye disease, continues to go undetected in many parts of the country, according to data compiled by Al-Shifa Trust Eye Hospital.

ROP occurs when abnormal blood vessels develop in the retina of premature infants and can result in permanent blindness. The condition is largely preventable if it is identified and treated in time, but access to screening and treatment remains limited, with only a small number of hospitals providing regular ROP screening services.

Pakistan recorded an estimated 921,600 preterm births in 2020, placing it among the countries with the highest number of such births globally. The country’s preterm birth rate stood at 14.4 per cent, ranking Pakistan fourth in the world in total preterm births and third in neonatal deaths.

Clinical studies cited in the data show that 32.2 per cent of eligible premature infants in Pakistan develop ROP. This is significantly higher than the 12 to 18 per cent reported in high-income countries.

A 2025 study published in BMC Ophthalmology linked the heavier burden in Pakistan to improved survival among premature babies without a corresponding increase in screening and treatment capacity.

Shortfalls in infrastructure and trained personnel remain a major challenge. In Peshawar, only two out of seven neonatal intensive care units that had ophthalmology services also had staff able to carry out ROP screening. In Balochistan, neonatal intensive care units included in a survey did not have the essential equipment needed for screening.

Research at Lahore General Hospital also pointed to major gaps in coverage. The study found that only 46.7 per cent of 3,521 eligible infants were screened between 2015 and 2021.

The consequences of untreated ROP can be severe. One study found that 76.4 per cent of affected children became completely blind, while 23.6 per cent developed severe visual impairment.

The figures underline the scale of a preventable health problem affecting premature infants in Pakistan, where survival gains among newborns have not been matched by wider access to timely eye screening and treatment services.