Preemies eyes not being properly protected during phototherapy used to treat jaundice at Huntsville Hospital's Women and Children's Center Neonatal ICU (NICU) in Huntsville, Madison County, Alabama. Huntsville Hospital for Women and Children

Do/Did you have a newborn infant undergoing phototherapy treatment for jaundice?

Does/Did your child have proper eye protection?  My Grandson didn't.

Severe eye problems due to preemies eyes not being protected, as phototherapy used to treat jaundice can cause damage to the nerve layer at the back of the eye, the retina, if the eyes are not properly protected from the light.

Is there a correlation between severe eye problems and improper eye protection while undergoing phototherapy?  That's what I'm trying to find out and that's what I'm beginning to believe.

If you have a child in any N.I.C.U. who has to undergo phototherapy, please be vigilant with the nursing staff and try to be there as much as possible to make sure that your little bitty one's eyes are being protected.  They are dealing with a child's eyesight for crying out loud, it's not like they are dealing with a hang nail or something, but unfortunately some hospital's obviously do not take eye care and protection seriously at all, as it's simply "just not a concern".

Most new parents with infants in the NICU are very overwhelmed and scared and should be able to trust the hospital staff in caring for their child, but remember, nobody will care for, or about your child the way you will!

On every website I can find it is stated that the eyes must be protected while the child is undergoing phototherapy and that the infant's temperature must be monitored carefully.

Some text from the New England Journal of Medicine - Feb. 28, 2008:  Because light can be toxic to the immature retina, the infant's eyes should always be protected with opaque eye patches.

I do not know what kind of lights the baby was under or who manufactured them.  I have no photos of the lights, just the baby under the lights.  All I know is that they were blue lights.

Here are two photos my son sent me when he went to the hospital to visit the baby after he was first placed under the lights.  He was approx. 2 days old.  (I'm not sure of the exact date and time he was placed under the lights).  How long he was like this, we don't know.  He was most likely not even checked on since his last feeding which had been approx. 3 hours before.

The other photos were taken by me when I went to visit because I didn't really have any photos of him, but I took the blue out of the photos.

The first photos below show how he looked nearly every time I went to see him,  if the mask was not off completely then the lower part was up near his eyebrows and his eyes were totally exposed.  Eye patches were never put on him as added protection.

I had fixed his eye mask numerous times, as well as my husband, son, and daughter in law and we all expressed our concern to the nurse on duty at the time and each time we were told that it wouldn't cause any harm.  We obviously had too much trust in these people.  I just wish I had brought my camera each time (but I didn't because all my pictures were blue and I didn't really want pictures like that) and after speaking with the nurses numerous times I thought/hoped/prayed they'd keep a better eye on the baby.

The hospital has a SPEAK UP policy and I definitely voiced my concerns to his nurses on duty at the time, but it was obviously falling on deaf ears, as I expressed concern to each and every nurse I came into contact with when he was under the lights, but was continually told that basically, the lights wouldn't do any harm or damage.  Did they know this for a fact?  Then why the use of the eye masks at all?

By the time I started reading online about the possible damaging effects to a baby's eyes and I was fuming and actually almost on my way to talk to the Hospital Administrator my son told me that he was off the lights for good and I felt by then that it was too late to do/say anything else.

I absolutely do believe in phototherapy treatment, but I also believe there should be mandatory protection and precautionary measures taken during treatment.  We don't sit in the room of another person having an x-ray, do we?  Women wear heavy lead aprons during x-rays when, or in case they are pregnant, don't they?  Those are standard precautionary and protection measures taken during x-rays but precaution and protection is of "no concern" during phototherapy?  But then again, this is only a child's eyesight they are being completely lax about, as apparently it's no big deal.

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As you can see from the photos below, the eye mask is protecting his eyes because he's on his side, but look at how big it is in the back. When he was placed on his back that's how much too big it was in the front and it just slid right off, as in the photos above.  It's the same mask.  That mask was used for nearly, or over 24 hours, maybe except for feedings and care time, I don't know, for all I know since he was being tube fed the lights may not have been turned of at all even during those times.

 

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The day after, after my son expressed concern over the 1st mask, they then put this one on.  When I first went to see him at 10:00 a.m. the mask was on because he'd just got done getting tube fed, changed, etc. and was ready to sleep.  But as you can see it would not take much for it to come up enough to allow his eyes to be exposed and it was NOT on properly when my husband and I went there the next day.  He was on his back and the mask was up near his eyebrows so we fixed it (again).  When my son and daughter in law came later that day it was off of his eyes as well.  How many times had it come up that day and the day before?  We don't know, but this mask was used for 2 solid days before it was taken off for 24 hours (because his bili levels came down) and then this same mask was used again when he had to go back under the lights for a couple more days when his bili levels rose again.

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On the very last day that he was under the lights they seemed to have finally gotten it right.  They found a mask that seemed to fit him correctly even when he was on his back.  (Unfortunately, I do not have a photo of that one).  The style looked much different to me than the other two.  I just don't understand why that one wasn't put on him from the beginning.  I don't know if they put on a different mask, or just finally adjusted one of them properly, but it looked as if that's how it should have been on him all along, unfortunately for him though, the better fitting one was on for only on for a couple of hours but the improperly fitted ones were on for days.

My Grandson was in the NICU where they specialize in preemie care and was over 3 1/2 lbs. yet they could not find a mask to fit him properly and never once put eye patches on him.  What about the babies much smaller than him?

How about a mask like the ones on this page, which could be cut to size and would stay on infants of any size?

This is a brand new, state of the art, high tech facility, but yet they do not even have proper fitting eye masks?  That's just ludicrous.

I am still very ticked off, even though he's off the lights and has been off since March 6th or 7th, I wrote a letter and am sending it to anyone who will read it and possibly be able to give me some kind of answers.  I emailed a copy of the letter to the hospital that the baby is at., but wasn't sure where it would end up and who would receive it.  But I redid the letter just a bit and took someone's advice and emailed the Administrative Office of that hospital because even though it may be too late for my Grandson, maybe I can help other babies.  I just wish I had done it much sooner, but I had been too busy trying to find some definitive answers online while many of the nurses at the hospital were pooh poohing me.

Unfortunately though, there are no definitive answers, because a study like that just cannot and should not ever be done.

I emailed a similar copy to Natus.com, the makers of the neoBLUE phototherapy light, as well.  You can see their response on my emails and sources page.  I also sent a copy to the March of Dimes and the National Eye Institute on March 18, 2008 and many, many others on March 17th.  Some of the replies I have received tell me to speak with the neonatologist  but most have said that it would be wise of me to bring it up with the Hospital Administration.

If you are interested in the letter I emailed to the hospital Administration Office you can click HERE to read it.

Note:  An N.I.C.U. Nurse emailed me concerning my letter.  You can view her email and my response here.  My daughter in law and I also spoke with two Nurses and one of the Neonatologists on Friday, March 21, 2008, his answer to me is under updates.

I received numerous emails in answer to my question.  That is also on the sources page.

I have had several emails from people/organizations telling me that since my Grandson was so close to 32 weeks gestation that his eyes should be okay, I certainly hope so.  Although the Dr. never did reassure us that because of his gestational age that he would be okay, he just kept insisting that the eye mask coming off was "really of no concern" and  "the lights have never caused any harm to any babies", period even though they DON'T KNOW.

But what about the little bitty tiny preemies born before 32 or 31 weeks?  What about their masks falling off all the time and their eyes being totally exposed?  Of course, any damage that could arise from that will be totally attributed to the fact that he/she is a preemie, and well, that's basically to be expected so why bother to even try to take any type of protectional measures, just in case.

Sep. 12, 2008:  It looks like after 6 months and a 2nd eye exam we are finally getting some answers.  Apparently my grandson cannot focus either up close or far away.    SEE UPDATE:

I do realize that the NICU also deals with many emergency and life threatening issues, and since eye mask protection isn't a life threatening issue it cannot be at the top of the list, but shouldn't it at least be ON the list for the times when they're not too busy?  When they get through dealing with all of the important issues can't they at least make some time to check and make sure that these babies have proper eye protection as apparently probable eye damage is just not concerning to them at all.

This is the way the baby's eyes looked upon his discharge a MONTH later.

I do believe that was due again, to inadequate eye care at the hospital, as once his mother was able to take care of his eyes herself, they cleared up very quickly.