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Screening of retinopathy of prematurity (ROP) - clinical guideline

ROP is one of the few causes of childhood visual disability that is largely preventable. This evidence-based guideline is by RCPCH in collaboration with Royal College of Ophthalmologists (RCOphth) and British Association of Perinatal Medicine (BAPM), published in 2022 and revised in October 2024.

Also available are a printable examination recording form, a summary of recommendations and an information leaflet for parents and carers.

It complements the RCOPhth guideline on the treatment of ROP.
Neonate in blanket

»Ê¼Ò»ªÈË ROP

Many extremely preterm babies will develop some degree of retinopathy of prematurity (ROP) with the majority of cases never progressing beyond mild disease, resolving spontaneously without treatment. However, a small proportion develop potentially severe ROP which can be detected through retinal screening. If untreated, severe disease can result in serious vision impairment and consequently all babies at risk of sight-threatening ROP should be screened on time.

»Ê¼Ò»ªÈË the guidelines

The original guideline, UK Screening and Treatment of Retinopathy of Prematurity was developed by RCPCH, RCOphth, BAPM and Bliss in 2008. This was reviewed in 2013 and updated in 2022 into two guidelines: Screening of ROP and Treatment of ROP.

The guidelines will next be reviewed in 2027.

Screening of ROP (RCPCH guideline)

RCPCH updated the screening guideline in 2022 and revised it in 2024, in accordance with our process manual, Setting standards for development of clinical guidelines in paediatrics and child health (2020).

You can download the guideline and related materials below:

  • full guideline
  • summary of recommendations
  • printable examination recording form
  • parent and carer information leaflet (also available on a separate webpage)
  • RCPCH screening calculator to help plan the timing of ROP screening appointments for eligible babies
Guideline review in 2024 - summary of changes

The ROP guideline development group was reconvened to carry out a rapid guideline review in light of new evidence.

  • The recommendation on screening criteria to include infants born less than 31 weeks gestational age (postmenstrual age) or with birthweight lower than 1501g remains as in the 2022 guideline.
  • An additional recommendation on screening criteria is added with the consideration to screen those infants born between 31+0 and 31+6 weeks’ gestational age. 
Guideline update in 2022 - summary of changes

The current guideline takes into account significant changes in both the clinical and organisational aspects of neonatal care since the original guideline was published in 2008. Updates included:

  • Gestational age criterion for screening was reduced from 32 weeks to 31 weeks (in the 2024 update, a recommendation to consider screening infants born between 31+0 and 31+6 weeks’ gestational age). Note the birthweight criterion of less than 1501g in the 2008 and 2022 guidelines did not change
  • Precise timing of the first examination
  • Detail on the preparation for screening, including consent, comfort care and pain relief during the screening examination
  • Emphasis on the importance of attending follow-up examinations, including the need for appropriate resuscitation equipment and trained staff
  • Detail on when to refer for treatment
  • Emphasis on record keeping and communication both with parents/carers and between professionals as well as the role of a ROP service coordinator
  • An algorithm for observations and a screening record form
  • Comprehensive appendices with full details of the guideline scope, methodology and development

Treatment of ROP (RCOphth guideline)

RCOphth updated the Treatment of ROP topic, including the full guideline, executive summary, and information leaflet for parents and carers. These can be found on the .


A  including both the screening and treatment guideline recommendations was published in the Early Human Development Journal in March 2023. This article does not include recommendations from the 2024 review. 

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