Aggressive posterior retinopathy of prematurity is encountered not only in low birth weight infants, but also in heavier and more mature Asian Indian infants. Early, aggressive confluent laser photocoagulation is necessary to maximize outcomes in these eyes.

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Our study shows that lack of screening is responsible for stage 5 ROP in outborn infants. More needs to be done to spread awareness about the disease. Broader screening guidelines are needed to ensure screening for infants>1500 g birth weight.

Some eyes with ROP may have abnormal neovascularisation resembling both APROP and classical staged ROP. It is difficult to characterise these eyes according to the international classification of ROP. However, the presence of plus disease should serve as guide to treatment.