On days when the pediatric ophthalmologist visits the NICU to perform ROP exams, certain practices will hopefully make the experience easier for everyone involved.

1)                  When a bedside nurse is notified that her patient will receive an ROP exam, (s)he should verify the patient’s name on the orders and the consult sheet.  If there are any questions about the appointment, the case managers keep a schedule of the infant’s initial and follow-up eye exam dates.

2)                  In deference to the time limitations of our ophthalmologic colleagues, no more than 10 ROP exams should be scheduled on any one day.  If more infants than this are due for an exam, the case managers and physicians should collaborate to triage patients based on risk and need.  In the event that > 10 neonates need an exam in one week, the ophthalmologists are occasionally and kindly able to make a second visit.

3)                  The nurse should wait to administer the Cyclomydril eye drops until the ophthalmologist calls to alert the nursery with an estimated time of arrival.  (The ophthalmologists also have to balance a busy clinic and consultation schedule, but will attempt to come to the nursery in a timely fashion after the infants’ eyes have been dilated.)

4)                  The nurse should also obtain a syringe of 24% sucrose water for her patient.  Eye exams are uncomfortable, and 24% sucrose should be routinely administered 2 minutes prior to examination.

Discussed at Nursery Policy & Procedure meetings 8/15/01 and 9/19/01.