As affected newborns have no symptoms, diagnosis in high-risk preterm infants depends on a careful ophthalmologic examination carried by a retinal specialist or pediatric ophthalmologist in a neonatal care unit.

In general, guidelines for screening include:

    • Infants born at 23-24 weeks should be examined within three to four weeks;
    • Infants born at or beyond 25 to 28 weeks should be examined by the fourth to fifth week;
    • Infants born after 29 weeks should be examined prior to discharge from the hospital.


Eye examinations every six months are recommended for all infants born under 32 weeks or that weigh less than 1500 g. Screening can stop if the blood vessels in both retinas have completed normal development. Newborns who developed severe retinopathy must have life-long eye examinations at least once a year.

Differential diagnosis

The main differential diagnoses of ROP are familial exudative vitreoretinopathy (FEVR) and Persistent fetal vascular syndrome also known as Persistent hyperplastic primary vitreous.