EFFECT OF NURSERY ILLUMINATION ON THE INCIDENCE OF RETINOPATHY OF PREMATURITY |[lpar]|ROP|[rpar]|

The preterm infant is subjected to prolonged exposure to ambient nursery illumination at levels that have been found to produce retinal damage in animals. The effect of light exposure in the nursery on the incidence of ROP was investigated in two level III nurseries. One hundred eighty-three infants with birthweights ≤ 2000g. and GA ≤ 34 weeks were admitted to the study. (Infants >1500g had to have received O2). One group of infants from each hospital was protected from the ambient lighting by the addition of a neutral density filter to the incubator. The Control infants were from the regular nursery environments. The infants were routinely examined by ophthalmologists for ROP at discharge or shortly thereafter. The results indicate less incidence of ROP in the Protected Group, particularly for those with BW ≤ 1000g, the infants most susceptible to ROP (X2=19.79, p<.001). The trend is similar within each hospital. These findings are further substantiated by an epidemiological study of infants in the Protected Group who had been in the same nursery. Fourteen ROP infants were matched for BW with 10 Non-ROP infants. The chance of being in a bed next to the window, and therefore "sun-exposed", is 25%. These ROP infants were more likely to have been "sun exposed" than the Non-ROP infants (79% vs. 10% respectively, p<.01). These associations between light level and incidence of ROP suggest that the ambient illumination in the hospital nursery may be one factor contributing to ROP. This study has important implications for the early care of infants at risk.