In this case report, we discuss the presentation of retinopathy of prematurity in triplets born at 25 + 3 weeks gestational age of whom each had a different birth weight, weight gain and treatment requirements. Triplet A weighed 800 g and his retinopathy of prematurity had resolved with no intervention. Triplet B weighed 630 g at birth and he required bilateral intravitreal ranibizumab injection at 32 + 6 weeks. Triplet C weighed 520 g and required bilateral intravitreal ranibizumab injection at 36 weeks, but after 5 weeks he had recurrence which was treated with bilateral diode laser. Triplet C had the poorest weight gain. The main differences between the triplets are the birth weight and the weight gain. Furthermore, refraction was performed at 10 months; triplet A had a hyperopia of +1.25 spherical equivalent in both eyes, triplet B had mild myopia of −0.25 spherical equivalent and triplet C had a myopia of −3.00 spherical equivalent in the right eye and −2.75 spherical equivalent in the left eye.

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