Retinopathy of prematurity (ROP) blindness is largely preventable, with many countries having already established programs for its timely identification. However, ∼93% of infants screened do not develop ROP severe enough to require treatment. As reported in this issue of Pediatrics by Coyner et al. artificial intelligence (AI) is innovative methodology to optimize the timing of ROP examinations. For example, it can predict whether an eye will not require treatment, reducing the number of examinations needed while also predicting which eyes need closer surveillance. This is an important development because it would make ROP programs more effective and efficient, thus reducing the burden on infants, families, and the health care team.

From the earliest descriptions, congestion and tortuosity of the posterior retinal vessels were recognized as prominent features of serious ROP. In the first international classification of ROP in 1984, the term “plus disease” was included to...

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