Military medical professionals are often tasked with helping people who are in the physical prime of their lives: Otherwise fit young women and men who become injured or ill. But a small group of doctors and nurses tend to the most physically vulnerable of military family members - premature babies.
Among that group of infants, those born weighing under three pounds are at a significant risk of retinopathy of prematurity (ROP), a potentially blinding disease. Those at risk for ROP must be evaluated from a certain point in their development until the determined danger period passes.
ROP is an eye disorder caused by abnormal blood vessel growth in the light-sensitive part of the eyes (retina) of premature infants born before the 31st week of pregnancy (seven to 10 weeks early). In most cases, ROP resolves itself without treatment. But advanced ROP can cause permanent vision problems such as detached retinas, leading to blindness.
"We would call retinopathy of prematurity a high-risk, low-volume ophthalmology disease," said Navy Capt. (Dr.) Lisa Peterson, a pediatrician at the Naval Medical Center San Diego (NMCSD) in California and neonatology specialty advisor for the Navy's Bureau of Medicine and Surgery. "Generally, we're looking at babies born before 30 or 31 weeks of gestation. That population nationwide is about 1.4 or 1.5 percent of all births. ROP is definitely low-volume, but because of the severity, without adequate tracking and detection and treatment, it could lead to blindness."
Military Health System pediatric ophthalmologists and vision care service coordinators are increasingly paying attention to the risk of ROP because of a marked decrease in troops with eye injuries compared to the height of the wars in Iraq and Afghanistan. But perhaps there's an even more practical reason to stay on top of diseases affecting premature babies, or preemies.
"Soldiers are having babies left and right," said Army Col. (Dr.) Frank Valentin, pediatric ophthalmology chief at the Brooke Army Medical Center at Fort Sam Houston, Texas.
Numbers have gone down since the COVID-19 pandemic began, but in 2018, there were 36,000 births across the Department of Defense (DOD), he said. In 2017, there were 39,000; 43,000 in 2016; and 45,000 in 2015.
"If we take care of our military families with the highest quality of care, with excellence, our warriors can focus on the mission and worry less for their loved ones back home," he said.
Peterson agrees.
"For families, it's not simple," she said. "They not only have the stress of a new baby at home, but also a new baby who has multiple chronic conditions from being in the NICU and being extremely premature, and sometimes navigating a health system. And all of that can be difficult on its own."
But within MHS treatment facilities, the process works well, she added.