Peru: Saving The Sight Of Triplets At Risk Of Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is a condition that causes abnormal blood vessels to grow in the retina, causing it to detach from the back of the eye. Without proper treatment, it can lead to blindness. In fact, it is one of the leading causes of childhood blindness worldwide.

The condition is fairly rare in the United States, where rates of prematurity are lower and effective preventive treatments are standard practice. But in middle-income countries, ROP remains a problem. Approximately 8,200 newborns are at-risk for ROP each year in Peru, where Elisa lives. In 2019, her triplets were among them.

The news that Elisa’s babies were at risk for ROP came amidst already difficult circumstances. The hospital in her hometown hadn’t been able to accommodate Elisa’s high-risk pregnancy, so they referred her to a more advanced facility in Lima. Five months into the pregnancy, doctors detected danger of an early birth, and Elisa was admitted to the hospital for a week.

Despite the scare, the expectant mother—who already had three boys at home—was happy and excited. “I was really happy five months in after seeing the sonograms! They told me it was going to be three girls,” she said, laughing, “so I now have a balance.” At six months and three weeks, Elisa was hospitalized again. This time, doctors told her she would have to stay until the babies were born.

When the time came at 32 weeks, complications were such that Elisa had to be transported by ambulance to yet another hospital. It was there, at Orbis’s partner Santa Rosa Hospital, that she welcomed her three tiny new daughters into the world. She named them Ruth, Sara, and Ester.

“I was lucky that when I gave birth, it was in a hospital with five incubators,” she said about the NICU at Santa Rosa Hospital. “My babies took up three!”

Every day at noon, the doctors gave Elisa a report on the babies’ progress and whether they needed any services or treatments. Since the babies were at risk for ROP, they explained to her what the condition is and recommended a screening procedure that is available at Santa Rosa through an Orbis project.

Dr. Luz Gordillo, pediatric ophthalmologist at Instituto Damos Vision, an Orbis partner, came to the hospital and screened all three triplets the next day.

Baby Ester was fine, with healthy eyes and no indication of ROP. Baby Sara was diagnosed with stage-1 ROP. This is a mild case that often clears up on its own without further treatment. Luckily, that’s what happened with Sara; she was able to heal on her own.

Baby Ruth, however, was in a more advanced stage of ROP. Without prompt and proper treatment, she would likely lose her sight.

“When they first told me there was a condition, we were scared because they mentioned it was a possibility that our child could become blind,” Elisa said, cradling Ruth in her arms.

And there’s so much that Elisa wanted Ruth to grow up and see with her own eyes. Family birthday celebrations, for example. “For each birthday, I decorate the house, I use balloons, I bring candies, and invite other children,” she said. It’s cherished time with family and friends, and Elisa takes great care to make it special. “That is really important to me, and Ruth wouldn’t have been able to see it.”

The doctors told Elisa that Ruth needed a laser treatment on both eyes, and explained how the procedure worked. “We said, of course! It was our only option.”

Dr. Gordillo performed Ruth’s laser treatment at Santa Rosa Hospital while Elisa and her husband waited in the waiting room. When it was done, they visited their baby in the NICU. Little Ruth had bandages over both eyes.

Then they waited eagerly for another day—that’s how long Ruth’s eyes needed to rest before Dr. Gordillo could evaluate whether the procedure had been successful. When Ruth’s bandages came off the next day, the news was good. The laser treatment had been successful.

Ruth needs continued follow up for her eyes, and all three triplets need ongoing physical therapy. Elisa’s hometown hospital isn’t equipped to meet these needs, so she travels back to Santa Rosa—a three-hour journey—to get her daughters the care they need. Her sister and cousin help Elisa bring the girls to their appointments. Even though the journey to the hospital is long, Elisa is grateful that the follow-up eye care Ruth needs is available at all. After all, she had to go to three different hospitals before finding a place to give birth to her premature triplets and get the ROP care they needed.

Ruth, Sara, and Ester are now five months old, and their personalities are starting to show. Ruth is the rambunctious one, and the leader. “The second Ruth starts crying, the other two follow suit!” Elisa laughed. “I am so happy now because I can see how much they have grown. I have three growing daughters!”

“For my family, I want us to be able to work hard, to succeed. For my daughters, I want them to be able to go to school, to find careers that they enjoy, to become professionals in their lives.”