Retinopathy of prematurity (ROP) is a condition that can occur in premature babies when abnormal blood vessels grow in the retina. High risk babies are those born prematurely at <32 weeks, <1500 grams or required a lot of oxygen after birth. The condition can cause the retina to detach and lead to blindness. There are generally no symptoms associated with the condition, so it can only be diagnosed through an eye examination. Laser surgery is conducted in order to stop the growth of abnormal blood vessels.
During the procedure, tiny laser spots are used to burn away the peripheral retina where the abnormal blood vessels are located. Cryotherapy is another surgical treatment and involves freezing the peripheral retina in order to stop the growth of abnormal blood vessels. Since laser treatment has become available, cryotherapy is very seldom used. In some cases, injecting anti-VEGF into the eye can also be performed.
Dr Enslin Uys used to regularly examines these tiny babies and still has the knowledge and experience to advise the best treatment for your baby. This usually takes place while your baby is in Neonatal ICU (NICU).
Paediatric Eye Specialist FAQ
- What exactly is a pterygium, and what causes it?
- Who needs ROP screening in South Africa?
Babies born weighing less than 1500g or before 32 weeks gestation require ROP
screening. In South Africa, screening is also recommended for larger infants (1500g–
2000g) who experienced medical instability, such as multiple blood transfusions or
respiratory distress. If you are in Pietermaritzburg or KwaZulu-Natal, Dr. Enslin Uys
can confirm if your baby meets these specific clinical criteria. - Is ROP screening painful for my premature baby?
No, ROP screening is not considered painful as medical comfort measures ar
used. To ensure your baby remains calm and comfortable, we use:
Topical anaesthetic eye drops to numb the surface of the eye.
Oral sucrose (sugar water) for natural pain relief.
Non-nutritive sucking (a pacifier) during the brief examination - Can ROP resolve on its own without treatment?
Yes, the majority of ROP cases resolve naturally without medical intervention. Mos
instances are classified as Stage 1 or Stage 2 and do not progress. However,
regular screening is essential because a small percentage of babies develop
aggressive ROP that requires urgent treatment to prevent permanent vision loss. - What is the difference between laser treatment and Avastin for ROP?
The primary difference is how they stop the progression of the disease
Laser Therapy: Uses a precise light beam to treat the peripheral retina,
stopping the growth of abnormal vessels.
Avastin (Bevacizumab): An injection of “anti-VEGF” medication that
chemically blocks the signals telling abnormal blood vessels to grow.
Dr. Enslin Uys determines the best approach based on the ROP stage and
the baby’s overall health. - Why is my baby being referred to a tertiary hospital for ROP screening?
Babies are referred to tertiary hospitals because ROP screening requires highly
specialised ophthalmic equipment and expertise not available in most local clinics. In
KwaZulu-Natal, screening is centralised at these facilities. Dr. Enslin Uys accepts referrals from across the region to ensure every high-risk infant in Pietermaritzburg
has access to specialist care. - How important is follow-up after ROP treatment?
Follow-up appointments are critical to protecting your baby’s long-term vision. In
South Africa, nearly 46% of infants are “lost to follow-up” after discharge, which is
the leading cause of preventable blindness. Because ROP can change rapidly, every
scheduled visit with Dr. Enslin Uys must be prioritised. - Can ROP cause permanent blindness if left untreated?
Yes, severe untreated ROP can lead to retinal detachment and total, permanent
blindness. Fortunately, this is almost entirely preventable. Early detection through
routine screening and timely intervention by a specialist like Dr. Enslin Uys is the
most effective way to ensure your child grows up with healthy vision. - When should my child have their first eye test?
A child’s first comprehensive eye exam should ideally occur at 6 months of age,
followed by a check-up at age 3. These early milestones ensure that visual
development is on track and that any congenital issues are identified before they
affect learning. To schedule your child’s first examination in Pietermaritzburg, you
can contact the rooms of Dr. Enslin Uys. - When is surgery necessary for a pterygium?
Surgery is recommended when a pterygium causes persistent irritation, affects your vision, or becomes cosmetically unappealing. If the growth begins to pull on the cornea, it can cause astigmatism or eventually block your sight. Dr. Enslin Uys evaluates patients in Pietermaritzburg to determine if the growth is stable or requires surgical removal.
- How can an eye specialist test a baby who can't read or talk yet?
Paediatric eye specialists use objective, non-verbal testing methods like Retinoscopy
and LEA symbols to assess vision. Retinoscopy allows Dr. Enslin Uys to determine a
child’s prescription simply by observing how light reflects off the retina, while LEA
symbols use simple shapes (like houses and apples) instead of letters. These child-
friendly techniques are highly accurate for infants and toddlers in our
Pietermaritzburg practice. - What signs of vision problems should I look for in my child at home?
Common warning signs of vision issues include squinting, frequent eye rubbing,
sitting too close to the TV, or tilting the head to see clearly. You may also notice poor
hand-eye coordination during sports or a lack of interest in reading. If you observe
any of these behaviours, a comprehensive eye examination with Dr. Enslin Uys is
recommended to rule out underlying refractive errors. - Can undetected vision problems affect my child's school performance?
Yes, undetected vision problems can significantly hinder academic performance,
roughly 80% of classroom learning is visual. Children with uncorrected vision often
struggle with reading, writing, and concentration, which can be misdiagnosed as
learning disabilities. Early detection by Dr. Enslin Uys ensures that your child has the
visual tools necessary for educational success. - Is a school vision screening enough for my child?
No, a basic school screening is not a substitute for a comprehensive eye
exam. Research indicates that school screenings can miss up to 60% of children
with vision problems because they typically only test distance acuity (the 20/20 line).
A full exam with Dr. Enslin Uys evaluates eye muscle coordination, focusing ability,
and overall ocular health, which screenings do not cover. - How often should my child have follow-up eye tests?
Children with healthy vision should have an eye test every two years, while those
with glasses or tracking issues generally require annual exams. Frequent testing is
vital during growth spurts when eye shape and prescription can change rapidly. Dr.
Enslin Uys will provide a personalised recall schedule based on your child’s specific
visual needs. - How much does a children's eye test cost in South Africa?
The cost of a paediatric eye exam varies based on the complexity of the tests, but
most South African medical aids provide coverage for these consultations. Because
many schemes have specific sub-limits for optometry or ophthalmology, it is best to
contact Dr. Enslin Uys’s rooms in Pietermaritzburg directly for a quote and to confirm
your medical aid benefits - Does my child actually need squint surgery, or can glasses and patching fix it?
Not every child with a squint requires surgery; many cases are successfully treated
with glasses, patching, or eye exercises. The treatment depends entirely on the type
and severity of the eye turn. Dr. Enslin Uys provides comprehensive assessments in
Pietermaritzburg to determine if non-surgical options are sufficient or if surgery is
necessary to correct the alignment. - What is the best age for squint surgery in children?
The best outcomes for squint surgery are generally achieved before the age of 6 or
7. Early intervention is critical because it gives the brain and eyes the best chance to
develop healthy binocular vision. Dr. Enslin Uys recommends an early assessment
rather than a “wait-and-see” approach to avoid permanent visual developmental
delays. - What is the success rate of squint surgery in children?
Squint surgery has a success rate of approximately 70% to 80% for achievin
correct alignment in a single procedure. While most children see immediate
improvement, some may require a second follow-up procedure to reach the best
results. During your consultation in Pietermaritzburg, Dr. Enslin Uys will provide a
realistic success forecast based on your child’s specific condition - Will my child's eye be removed during squint surgery?
No, the eye is never removed or displaced from the socket during squint
surgery. This is a common misconception; the procedure only involves adjusting the
small muscles on the outer surface of the eyeball. Dr. Enslin Uys performs the
surgery entirely while the eye remains safely in its natural position. - How long does recovery take after squint surgery?
Most children can return to school within 2 to 7 days after surgery, with full healing
typically taking 4 to 6 weeks. While the eye may appear red for a few weeks,
discomfort is usually minimal. Dr. Enslin Uys provides a detailed post-operative care
plan to ensure a smooth recovery for families in the KwaZulu-Natal region. - Is squint surgery covered by medical aid in South Africa?
Yes, squint surgery is often covered by South African medical aids and may be
classified as a Prescribed Minimum Benefit (PMB). Coverage usually applies when
the squint affects the child’s functional vision. You can contact Dr. Enslin Uys’s
rooms in Pietermaritzburg for assistance with the clinical motivation and pre-
authorisation required by your specific medical scheme - Is squint surgery purely cosmetic or functional?
Squint surgery is both cosmetic and functional, as it improves the appearance of th
eyes and helps them work together. While “cosmetic” refers to the eyes looking
straight, “functional” success means the brain can achieve proper binocular vision.
Dr. Enslin Uys will discuss which outcomes are achievable for your child during their
initial evaluation. - Does corneal transplant surgery hurt?
No, corneal transplant surgery is typically painless as it is performed under local
anaesthesia with sedation or general anaesthesia. You may feel a “gritty” sensation
or mild discomfort for a few days following the procedure, but this is easily managed
with prescribed eye drops and over-the-counter pain relief.