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Stevie Wonder had this disease. It can still make infants blind
Why do some Norwegian hospitals treat infants’ eye disease more often than others?
It’s a mystery.
The eye disease known as retinopathy of prematurity (ROP) can make infants permanently blind if they are not treated.
But there are big differences between how often Norwegian hospitals actually provide this treatment.
The differences between hospitals
“These differences between the hospitals are inexplicable,” says Dordi Austeng.
She is a professor at NTNU's Department of Neuromedicine and Movement Science.
In principle, the proportion of newborns who develop this condition should be the same across the country.
“There should be no differences between hospitals in the proportion of premature babies who get this disease, and who therefore need to be treated. But there is,” she says.
But the unexplained often only needs a thorough investigation before it becomes explainable, and it was precisely such a study that Austeng and colleagues conducted.
Are some specialists stricter than others?
Could there be a difference between the ophthalmologists at the different hospitals?
Is the variation simply due to how ophthalmologists decide that the eye disease is so serious that it requires treatment?
“In our study, Norwegian ophthalmologists were tested to find out whether they are the cause of the regional differences in eye disease in premature babies,” says Austeng.
All ophthalmologists in Norway who examine these children and decide whether treatment is needed participated in the study – a total of 15 specialists.
The question was whether specialists at some hospitals are stricter than others.
But first, a little about the condition itself.
Stevie Wonder had this disease
'Incubator blindness' is an old name for the condition.
Today, professionals most often use the abbreviation ROP, which stands for retinopathy of prematurity.
The condition usually affects premature babies.
The blood vessels in the retina that line the inside of the eye are not fully grown in premature babies.
Very few children become blind today
"The risk of blood vessels growing incorrectly increases the earlier you are born and with oxygen therapy, among other things,” says Tora Sund Morken,
She is also a professor in the Research Group for Ophthalmology.
Stevie Wonder was born prematurely. He was an incubator baby in the early 1950s, and became blind because of this very disease.
“Today, fortunately, very few children go blind, as they are examined weekly by specialised ophthalmologists and treated if they are at risk of becoming blind,” says Morken.
But it's important to get the diagnosis. That is why the researchers carefully evaluated the specialists working at the hospitals.
Most treatment where doctors were strictest
“The doctors logged on to a website and completed a test that colleagues in the US have helped us set up,” says Austeng.
The results provided a very unexpected answer.
“The results showed that the ophthalmologists in the region that treated the most children were most restrictive in making the diagnosis of ROP that would require treatment,” says the researcher.
In other words, doctors made the diagnosis less frequently in the region where treatment was most common.
“This is the exact opposite result than what we expected if the ophthalmologists had overtreated the children,” says Austeng.
So what on earth is the reason for these differences between the hospitals?
Could it be due to survival rates or lung disease?
“Unfortunately, we don’t know the answer yet,” says Austeng, while pointing to several possible explanations.
There may be differences in survival rates between hospitals.
“We know that the most premature babies are sicker. This can result in a higher proportion of children with eye disease and more serious eye disease that needs treatment,” she says.
Other risk factors include infections or lung disease that require oxygen therapy.
It’s possible that there are differences between hospitals in the incidence and treatment of these diseases. The research group is still investigating this.
The researchers continue looking for answers
“The next step is to sift through data collected on the children in the Norwegian Neonatal Network,” says Austen.
This network includes records of all newborn diseases, and the treatment they receive from healthcare personnel.
“We hope to find more answers this year. What we know today is that the differences are probably not due to variation in the diagnosis of ROP requiring treatment,” says Austeng.
Reference:
Austeng et al. Inter-observer variability is unlikely to explain regional differences in retinopathy of prematurity in Norway, Acta Ophthalmologica, 2026. DOI: 10.1111/aos.70146
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Read the Norwegian version of this article on forskning.no
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