guidelines. Screening criteria and risk factors that are recognized in one country do not necessarily apply in another country where available perinatal care may not be comparable. Recognizing and treating ROP in a timely fashion is critical for achieving the best visual outcome. ROP and its sequelae can cause problems throughout a patient’s life; therefore, long-term monitoring by an ophthalmologist is crucial. Alice L. Bashinsky, MD pediatric ophthalmology and strabismus, Asheville Eye Associates, Asheville, North Carolina. Acknowledgments The author would like to thank Sharon Freedman, MD, Professor of Ophthalmology, Professor of Pediatrics, and Chief of Pediatric Ophthalmology at Duke Ophthalmology for the images used in this commentary. Potential conflicts of interest. A.L.B. has no relevant conflicts of interest. References 1. Sommer A, Taylor HR, Ravilla TD, et al. Challenges of ophthalmic care in the developing world. JAMA. Ophthalmol. 2014;132:640- 644. 2. Hartnett ME, Penn JS. Mechanisms and management of retinopathy of prematurity. N Engl J Med. 2012;367(26):2515-2526. 3. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results. Arch Ophthalmol. 1988;106(4):471-479. 4. Terry TL. Extreme prematurity and fibroplastic overgrowth of persistent vascular sheath behind each crystalline lens I: preliminary report. Am J Ophthalmol. 1942;25:203-204. 5. Campbell K. Intensive oxygen therapy as a possible cause for retrolental fibroplasia; a clinical approach. Med J Aust. 1951;2(2):48-50. 6. Ashton N. Oxygen and the retinal blood vessels. Trans Ophthalmol Soc U K. 1980100(3):359-362. 7. Fierson WM. American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2013;131(1):189-195. 8. Quinn GE, Barr C, Bremer D, et al. Changes in course of retinopathy of prematurity from 1986 to 2013: comparison of three studies in the United States. Ophthalmology. 2016;123(7):1595-1600. 9. The BOOST II United Kingdom, Aukstralia, and New Zealand Collaborative Groups.. Oxygen saturation and outcomes in preterm infants. N Engl J Med. 2013;368(22):2094-2104. 10. Löfqvist C et al. Validation of a new retinopathy of prematurity screening method monitoring longitudinal postnatal weight and insulin-like growth factor 1. Arch Ophthalmol. 2009;127(5):622-627. 11. Hellström A, Smith LEH, Dammann O. Retinopathy of prematurity. Lancet. 2013;382(9902):1445-1457. 12. International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123(7):991-999. 13. Chen J, Smith LE. Retinopathy of prematurity. Angiogenesis 2007;10(2):133-140. figure 3. Zone II stage 4A After Diode Laser Treatment Source. Courtesy of Sharon Freedman, MD. figure 4. Sedated Infant Undergoing Diode Laser Treatment for ROP in the NICU Source. Courtesy of Sharon Freedman, MD. NCMJ vol. 78, no. 2 ncmedicaljournal.com 128 14. Palmer EA, Hardy RJ, Dobson V. et al. 15-year outcomes following threshold retinopathy of prematurity: final results from the multicenter trial of cryotheraphy for retinopathy of prematurity. Arch Ophthalmol. 2005;123(3):311-318. 15. Chiang MF, Melia M, Buffenn AN, et al. Detection of clinically significant retinopathy of prematurity using wide-angle digital retinal photography: a report by the American Academy of Ophthalmology. Ophthalmology. 2012;119(6):1272-1280. 16. Paysse EA, Lindsey JL, Coats DK, Contant CF Jr, Steinkuller PG. Therapeutic outcomes of cryotherapy versus transpupillary diode laser photocoagulation for threshold retinopathy of prematurity. J AAPOS. 1999;3(4):234-240. 17. Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003; 121(12):1684-1694. 18. Mintz-Hittner HA, Kennedy KA, Chuang AZ; BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. 2011;364(7):603-615. 19. Darlow BA, Ells AL, Gilbert CE, et al. Are we there yet? Bevacizumab therapy for retinopathy of prematurity. Arch Dis Child Fetal Neonatal Ed. 2013;98(2):F170-174. 20.Capone A Jr, Trese MT. Lens-sparing vitreous surgery for tractional stage 4A retinopathy of prematurity retinal detachments. Ophthalmology. 2001;108(11):2068-2070. 21. Quinn GE, Dobson V, Barr CC, et al. Visual acuity of eyes after vitrectomy for retinopathy of prematurity: follow-up at 5 ½ years. The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Ophthalmology. 1996;103(4):595-600.