Screening and surveillance for retinopathy of prematurity: A Wilson and Jungner framework approach

Retinopathy of prematurity (ROP), a potentially blinding disease, has emerged in distinct epidemics, with low birth weight, gestational age, and exposure to oxygen identified as primary risk factors [1]. Understanding its epidemiology has highlighted the need for prevention through public health policies and interventions. In low-to middle-income countries, unmonitored oxygen exposure and lack of ROP screening have emerged as significant risk factors for ROP-related blindness [2]. While evidence-based approaches for oxygen targeting, reducing risk for sepsis, and optimising nutrition serve as primary prevention measures, ROP screening is equally critical in identifying at-risk infants and initiating timely interventions to prevent blindness. Wilson and Jungner's guidelines for disease screening have been a major reference for population-based screening decisions since their publication in 1968 [3]; by applying their "ten principles" to the ROP screening program, we aim to highlight the importance of early detection and treatment of ROP to prevent blindness and lifelong vision impairments in preterm infants.