Researchers in South Korea followed over 800,000 children born between 2014 and 2018 to understand whether retinopathy of prematurity (ROP)—a condition affecting blood vessel development in premature babies' eyes—was linked to later developmental delays. At age 54–60 months (roughly 4.5–5 years), they tested each child's development across six areas: self-care, thinking skills, language, fine motor control (small hand movements), gross motor control (large body movements), and social skills.
Of all the children studied, 0.92% had a history of ROP. These children had been born earlier and smaller than other babies, and were more likely to have vision problems as they grew.
ROP carries measurable risk across multiple developmental areas
Children with ROP history showed higher chances of developmental delay across most areas tested. The risk was strongest for gross motor development—children with ROP were 1.56 times more likely to show delays in this area. Thinking skills and language delays were also more common, though the increase was smaller. These findings held even after accounting for other factors like maternal health and birth weight, suggesting ROP itself signals a genuine developmental vulnerability rather than simply being a marker of prematurity alone.
Poor vision alongside ROP amplifies the risk
The study's most striking finding involved children who had both ROP history and subnormal vision (defined as eyesight worse than 0.6 in either eye) by age 4–5. For these children, developmental delays were more pronounced across all measured domains. This suggests that when the eye condition persists—meaning vision hasn't fully caught up—the impact on overall development becomes more significant.
Eye screening at school entry may catch children who need support
The researchers recommend using ROP history and vision checks as a flag for developmental surveillance before children start school. Because delays showed up across language, thinking, and motor skills—not just vision—children flagged this way may benefit from earlier assessment and targeted support in multiple areas, not just eyes.
Limitation: This study was conducted in South Korea and used that country's developmental screening tools. The findings may apply to Singapore's premature population, but would need local validation.