Retinopathy of prematurity in the UK II: audit of national guidelines for screening and treatment.
OBJECTIVE
To ascertain how closely in 1995, neonatologists and ophthalmologists were adhering to the national guidelines for the screening of retinopathy of prematurity (ROP, 1990) and those for screening and treatment (1995).


METHODS
Questionnaires about the local arrangements for the screening and treatment of retinopathy of prematurity were sent to the entire consultant membership (n = 648) of the Royal College of Ophthalmologists (RCOphth) and to the clinical directors (n= 259) of neonatal units in the UK in 1995.


RESULTS
One hundered and eighty-three ophthalmologists in the UK were identified as undertaking ROP screening and/or treatment, and ROP screening took place in 207 neonatal units. Seventy-seven per cent of the ophthalmologists either complied with or exceeded recommendations for determining which babies required screening, while 7% used criteria that would have resulted in substantially fewer babies being screened. Only 17% units and 12% ophthalmologists provided written information for parents, although 66% ophthalmologists talked to the parents of babies they screened. There was a lack of clarity about responsibilities for ensuring the continuation of screening on transfer to another hospital or on discharge to home. There was a wide range of views on the ophthalmic criteria that determined when screening examinations could cease and on the indications for treatment.


CONCLUSIONS
While ROP screening is almost universally adopted in the UK, there is a need for the process to be more efficient and effective. Despite the delay in reporting this survey several issues remain extant and future guidelines should clarify and refine the criteria for screening and treatment. There is a need for improved communication with parents, and particularly for written information.
Fielder
A R
AR
Department of Ophthalmology, Imperial College School of Medicine, Western Eye Hospital, London, UK. a.fielder@ic.ac.uk
Haines
L
L
Scrivener
R
R
Wilkinson
A R
AR
Pollock
J I
JI
D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007255:Information Services; D008485:Medical Audit; D015997:Neonatal Screening / Q000379:methods / Q000592:standards*; D009885:Ophthalmology; D010290:Parents; D017410:Practice Guidelines as Topic; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000628:therapy; D006113:United Kingdom