Effect of Bright Light in the Hospital Nursery on the Incidence of Retinopathy of Prematurity

Abstract

The preterm infant is subjected to prolonged exposure to ambient nursery illumination at levels that have been found to produce retinal damage in animals. We prospectively investigated the effect of exposure to light in two intensive care nurseries by comparing the incidence of retinopathy of prematurity among 74 infants from the standard bright nursery environment (median light level, 60 foot-candles [ftc]) with the incidence among 154 infants of similar birth weight for whom the light levels were reduced (median, 25 ftc). There was a higher incidence of retinopathy of prematurity in the group of infants who had been exposed to the brighter nursery lights, particularly in those with birth weights below 1000 g (86 percent vs. 54 per cent, P less than 0.01 by chi-square test). We conclude that the high level of ambient illumination commonly found in the hospital nursery may be one factor contributing to retinopathy of prematurity and that safety standards with regard to current lighting practices should be reassessed.

Effects of Blood Transfusion on Retinopathy of Prematurity

“…Other proposed risk factors that are under study and may not be causally linked to ROP include: metabolic acidosis (Bossi et al, 1984), metabolic alkalosis (Shohat et al 1983), hypercarbia (Bauer & Windmayer, 1981), hypocarbia (Brown,1987), transfusions (Brown,1987;Clark et al ,1981), light (Glass et al ,1985), intraventricular hemorrhages (Brown,1987), white race ( Saunders et al ,1997),chronic lung disease (Biglan et al ,1984), seizures (Biglan et al ,1984),sepsis (Gunn et al,1980),xanthine administration (Hammer et al,1986), magnesium and copper deficiency (Caddell,1995), Vitamin E deficiency (Owens & Owens ,1949 ),selenium deficiency (Papp & Nemeth& Pelle ,1993), and multiple gestations (Bossi et al, 1984). Any change that affects the incidence or nature of one or more of these risk factors might also affect the incidence and severity of ROP.…”

The development of potentially better practices to support the neurodevelopment of infants in the NICU

“…Continuous bright lighting has been linked to increased incidence of retinopathy of prematurity. 396 When light exposure to babies was reduced by having them wear goggles until 31 weeks gestation or 4 weeks after birth, there was no reduction in the severity or incidence of retinopathy of prematurity. 397,398 On post hoc analysis, this continuous darkness did not demonstrate any differences in weight gain or improved clinical morbidity.…”

Range of Thresholds Used for Treatment of Neonatal Hyperbilirubinemia at Different Gestational Ages across Neonatal Units in Great Britain

“…Although it is a relatively easy to provide phototherapy, it is not without potential side effects. Prolonged exposure to bright ambient light may damage cone photoreceptors [4] and increase the inci-dence of retinopathy of prematurity [5]. When infants are exposed to prolonged phototherapy, they may develop grayish-brown discoloration of the skin (bronze baby syndrome) [6].…”