Light Cycling for ROP

Specialties NICU

Published

Hi everyone. This is my first time posting, but I've been reading through all of your posts for a long time now. I've been a NICU nurse for about a year now and I've been asked to do my first "project". Our unit has been trying to make a consitent policy for how we do light cycling. Right now the NNPs just put in random times for various babies. I've been looking around for some research on light cycling and ROP but I'm not coming up with a whole lot. I talked to another nurse who did a small project on it during her capstone with NICU for school and she said she couldn't find a lot of info either. How do your units handle ROP and light cycling? Do you light cycle at all? I've read that it's done for the infant's circadian rhythm but we don't light cycle for that reason at all. Our unit is a little backwards on things. Any help would be greatly appreciated. Thanks!

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Specializes in NICU.

ROP isn't affected or caused by bright light. Light cycling is a good idea for other reasons but I don't know why it would be done in relation to ROP?

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Specializes in NICU, PICU, PACU.

We don't light cycle where I work, it is hard to do with 6 kids Ina pod and half the unit has natural light and the other half doesn't. We do keep it dim at times we aren't working and use isolette covers.

As the PP said, it doesn't really affect ROP, oxygen concentration is the biggest offender.

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Wow. Our unit is BIG on light cycling for ROP. We are trying to standardize a way to do it with specific times, certain lighting, etc. One of our NEOs teaches us and parents that light cycling keeps ROP from advancing. I have yet to find any information on it but he is adamant about it. A nurse last night told me that our physician that does injection treatments doesn't agree with the use of light either but is tired of arguing with our Dr so he stopped caring. Our unit feels soooo backwards from what I read that other places are doing. How do you keep ROP from progressing? Do you have injection treatments for severe and plus disease?

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Specializes in NICU, PICU, PACU.

Ask him for references ?. We keep our sats between 86-94 until fully vascularized. Our docs from the eye institute do laser, but we have a very low percentage of kids who need it.

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Specializes in NICU.

I have never heard of light cyling. Time to ask Dr. Google and Dr. PubMed :)

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Specializes in Neonatal ICU (Cardiothoracic).

Light cycling has no effect on progression of ROP. Targeted oxygen saturation and avoidance of preterm delivery do.

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Specializes in NICU.

I've seen it mentioned that there's not much info out there. I think that's because it's not supported by research. There seems to be a "following" that believes that fluorescent lighting causes ROP, not oxygen. Mildly entertaining, but still leaves me SMH.

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Specializes in NICU.

If light caused or worsened ROP, wouldn't we keep preemies blindfolded constantly, rather than worry about cycling the light?

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We keep our babies under a thick isolette cover from 23-31 weeks and keep their oxygen saturations at 85-93. At 32 weeks we remove the heavy cover and place a smaller lighter blanket over their bed and change their limits to 85-95. If they are still on O2. We are told that the best way to prevent ROP is preventing prematurity and over oxygenation. However, we also light cycle when/if they hit stage 2 (any zone). This doesn't happen with all our preemies but it's pretty common with our micros as they get older. Our Neo that believe in light cycling to help prevent progression of the disease is wanting us to determine set times. Right now it's random for each kiddo. From 8 all the way to 24 hours but at all random times of the day. And with the lighting in out unit it's not easy to expose one baby and not the other. I am having a hard time finding studies on light cycling. By reading your posts I am seeing that it's not a common processes anyway. That makes sense because our unit does things that don't make sense.

This (us having to look into out policy and procedure) all started with a former micro having advanced ROP and orders for 24 hr LC. This little guy was a 25 week twin. Him and his sister were brought in on NCPAP and within days on high freq with DNR statuses because they were so sick. Now 50 some days later they've made some improvement. Small but some.

I wanted some insight into other units. I'll take this back to the policy group and ask what my next step should be. If they want me to make something up, they can get all over that project themselves. :)

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Have you looked into just light cycling for growth? I think there's pretty good research supporting that if nothing else. When my son was in the NICU some articles I read did implicate early light exposure in ROP development.

Here's one that shows that the combo of light and O2 is deleterious.

http://www.retinopathyofprematurity.org/LIGHT_ROP_Manual01.htm#exposure%20to%20light

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Specializes in NICU.

Here's one that shows that the combo of light and O2 is deleterious.

LightROP_Manual01

That website appears to be slanted and opinionated. I'm not sure how he managed that domain name.

attempted to quote from PP rnkaytee

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