Compared Methods for Reducing Stress in ROP Exams; Stake-Holding Examiner Perspective.

Area of Science:

• Ophthalmology
• Neonatology
• Sensory Science

Background:

• Retinopathy of prematurity (ROP) staging requires invasive retinal examinations in infants.
• Understanding the sensory experience of these exams is crucial for infant welfare and stress reduction.
• Previous studies have not fully quantified the adult sensory perception of ROP examination components.

Purpose of the Study:

• To assess the perceived stress and sensory impact of ROP examination components on adults simulating infant exams.
• To compare adult sensory responses to known infant physiological responses during ROP staging.
• To evaluate the efficacy of topical anesthesia in mitigating sensory discomfort during these procedures.

Main Methods:

• Nine adults underwent 15 components of ROP examinations, including lid speculum, scleral depressors, and retinal photography.
• Participants were monitored with cardiac monitoring and self-reported pain/symptom scores (1-10 Likert scale).
• Examinations were conducted with and without topical anesthesia to compare sensory experiences.

Main Results:

• Topical anesthesia significantly reduced pain from lid speculum and scleral depression.
• High brightness levels from indirect ophthalmoscopy and retinal cameras caused significant discomfort.
• Adults experienced minimal oculocardiac reflex, unlike premature infants.

Conclusions:

• Topical anesthesia offers moderate pain relief during specific ROP exam components.
• A synergistic effect between pain and brightness exacerbates sensory stress.
• Adults do not replicate the bradycardia response seen in infants during ROP exams, highlighting species-specific physiological differences.