Development of blind infants and children with retrolental fibroplasia: implications for physicians.

Despite an apparent increase in the incidence of retrolental fibroplasia (RLF) and renewed interest in its pathophysiology and prevention, clinicians are often ill prepared to help the family promote the optimal development of its blind or severely visually impaired child. The physician's management approach is molded by both knowledge about the effects of blindness and prematurity on subsequent development and attitudes about blindness. Both issues are reviewed, with particular focus on the developmental course of the infant or child who is blind due to RLF. Although the literature regarding developmental outcome of premature infants with RLF has failed to reach definitive conclusions, studies reveal a tendency toward an IQ distribution similar to or slightly lower than that of various control samples. Blind children with RLF may also be at increased risk for emotional problems, largely as a function of early maladaptive family interaction patterns. Implications of these and other developmental patterns are translated into general and specific interventions that neonatologists, ophthalmologists, and primary care physicians can facilitate. Such physician guidance can help assure the blind or severely visually impaired child's optimal cognitive and emotional development.