Rawalpindi: Premature babies in Pakistan are losing their sight at rates far above global averages as a treatable eye condition, retinopathy of prematurity (ROP), continues to go undetected across large parts of the country, according to data compiled by Al-Shifa Trust Eye Hospital.
ROP develops when abnormal blood vessels grow in the retina of premature infants, which can lead to permanent blindness. Although timely screening and treatment can prevent most cases, access to ROP services remains limited, with only a small number of hospitals offering consistent screening.
Pakistan recorded an estimated 921,600 preterm births in 2020, placing it among the highest globally. The country’s preterm birth rate of 14.4 per cent ranks Pakistan fourth worldwide in total preterm births and third in neonatal deaths.
Clinical studies show that 32.2 per cent of eligible premature infants in Pakistan develop ROP, nearly double the 12 to 18 per cent reported in high-income countries. A 2025 study published in BMC Ophthalmology linked the higher burden to improved survival of premature babies without a parallel expansion in screening and treatment capacity.
Infrastructure shortages remain a major obstacle. In Peshawar, only two of seven neonatal intensive care units with ophthalmology services had staff capable of conducting ROP screening. In Balochistan, surveyed NICUs lacked essential screening equipment. At Lahore General Hospital, researchers found that only 46.7 per cent of 3,521 eligible infants were screened between 2015 and 2021.
Untreated ROP can have severe consequences; one study found that 76.4 per cent of affected children became completely blind, while 23.6 per cent developed severe visual impairment. Professor Dr. Sumaira Altaf, Senior Consultant and Head of Paediatric Ophthalmology at Al-Shifa Trust Eye Hospital, said the trust has been providing free ROP screening since 2010. A five-year study at the hospital found that 1,610 premature infants required more than 8,000 visits, leading to the diagnosis of 543 cases and urgent treatment for more than 250 infants.
The hospital has a dedicated ROP coordinator to track at-risk newborns and ensure follow-up screening, an approach uncommon in many hospitals, she said. The trust conducts workshops and training sessions for ophthalmologists. As a result, at least four hospitals in the twin cities now have Al-Shifa-trained specialists providing ROP services, while the screening network has expanded to hospitals in major cities of Azad Jammu and Kashmir, she added.
A January 2026 analysis of Global Burden of Disease data identified Pakistan as having the highest prevalence of vision loss linked to ROP globally, a trend likely to persist without policy intervention. Infants born at 35 weeks of gestation or earlier, or weighing two kilograms or less, face the highest risk and require screening within four weeks of birth.
