H35.173 Retrolental fibroplasia, bilateral

Name of the Condition

• Retrolental fibroplasia, bilateral

Summary

Retrolental fibroplasia, bilateral is a condition involving abnormal fibrous tissue growth behind the lens of both eyes, often associated with retinopathy of prematurity. This can lead to visual impairment or blindness if untreated. The condition primarily affects premature infants, with severity varying based on gestational age and other factors.

Causes

Retrolental fibroplasia is caused by abnormal retinal vascular development in premature infants. The retina, which normally completes vascularization by full-term birth, may not fully develop in preterm infants. Factors such as oxygen therapy, fluctuations in oxygen levels, and the infant's overall immaturity contribute to abnormal tissue growth behind the lens.

Risk Factors

• Prematurity (especially infants born before 31 weeks of gestation).
• Low birth weight (typically under 1500 grams).
• Oxygen therapy or fluctuations in oxygen levels during neonatal care.
• Multiple births (e.g., twins or triplets).
• Certain medical conditions affecting oxygen delivery or retinal development.

Symptoms

In early stages, retrolental fibroplasia may not present obvious symptoms. Severe cases can lead to abnormal eye movements, a white appearance of the pupil (leukocoria), or vision impairment as the child grows. Infants with this condition are typically asymptomatic initially.

Diagnosis

Diagnosis involves a comprehensive eye examination, including ophthalmoscopy to assess retinal blood vessel development and fibrous tissue presence. Imaging or specialized tests may be used to evaluate the extent of retinal damage. Bilateral involvement is confirmed by examining both eyes.

Treatment Options

Treatment depends on severity and may include monitoring for mild cases, laser therapy or cryotherapy to halt abnormal blood vessel growth, or surgical interventions for advanced stages. Early intervention is critical to preserve vision.

Prognosis and Follow-Up

Prognosis varies; early detection and treatment improve outcomes, but severe cases may result in permanent vision loss. Regular follow-up with an ophthalmologist is essential to monitor eye health and adjust care as needed.

Complications

Potential complications include retinal detachment, glaucoma, strabismus, or permanent blindness. Bilateral involvement increases the risk of significant visual impairment affecting daily functioning.

Lifestyle & Prevention

Prevention focuses on careful oxygen management in premature infants. For affected individuals, low-vision aids or rehabilitation may support daily activities. Protecting the eyes from injury is also important.

When to Seek Professional Help

Seek immediate medical attention if symptoms like leukocoria, abnormal eye movements, or vision changes occur. Early evaluation is crucial for infants at risk or showing signs of eye abnormalities.

Tips for Medical Coders

Use H35.173 for bilateral retrolental fibroplasia. Document laterality (bilateral) and any associated conditions like retinopathy of prematurity. Ensure clinical documentation supports the diagnosis and specifies both eyes are involved.