Baby born prematurely at 29 wks, on examination at 42 weeks with ROP, both eyes shows stage 2 zone 1 `plus’ disease, how will you manage the patient ?

**Core Concept**
Retinopathy of Prematurity (ROP) is a disease of the eye affecting prematurely born babies, characterized by abnormal blood vessel growth in the retina. The disease progresses through stages, with 'plus' disease indicating severe disease, often requiring treatment to prevent vision loss.

**Why the Correct Answer is Right**
In a premature baby with ROP, 'plus' disease in both eyes (stage 2 zone 1) indicates severe disease, requiring prompt treatment to prevent progression to retinal detachment and vision loss. Laser photocoagulation is the standard treatment for 'plus' disease, aiming to induce regression of the abnormal blood vessels by ablating the avascular retina, thereby reducing the risk of severe complications. Both eyes should be treated simultaneously to prevent asynchronous progression and subsequent vision loss.

**Why Each Wrong Option is Incorrect**
**Option A:** Delaying examination for a week would allow the disease to progress, increasing the risk of severe complications and vision loss. Prompt treatment is essential in ROP.
**Option C:** Treating only the worse eye would not address the risk of asynchronous progression in the other eye, leading to potential vision loss. Both eyes should be treated simultaneously.
**Option D:** Vitreoretinal surgery is typically reserved for cases with retinal detachment, not for the management of 'plus' disease in ROP.

**Clinical Pearl / High-Yield Fact**
In ROP, 'plus' disease is a critical threshold for treatment, as it indicates a high risk of severe complications. Prompt laser photocoagulation can significantly reduce the risk of vision loss in these patients.

✓ Correct Answer: B. Laser photocoagulation of both eyes.