As the incidence of premature births rises and the rates of survival improve as a result of advancements in neonatal healthcare, there remains a significant global population of infants who are susceptible to the development of retinopathy of prematurity(ROP), particularly in middle-income nations.
Risk of ROP differs according to economic situation, in developed countries, infants born with gestational age (GA) less than 28 weeks and birth weight (BW) less than 1 kg are at high risk of ROP, but in developing countries, these parameters differ as infants born with GA of 37 weeks or less and with BW of 2000 gm. or less are at high risk of ROP.
There is ongoing debate on the use of topical anesthetics with premature neonates during ROP examination. A seven-indicator composite metric called the preterm infant pain profile (PIPP) is used to gauge newborns' acute pain. Gestational age, oxygen saturation, heart rate, behavioral state, eyelid squeeze, nasolabial furrow and brow bulging are the indicators.