Back ground: Blindness due to Retinopathy of Prematurity is common in preterms.  Evaluation and Management if done early vision can be saved.  Aims: To study  prevalence , risk factors, impact of early diagnosis and management and outcome with or without treatment in babies of our NICU.  Design: Longitudinal , Analytical study. Setting: Neonatal intensive care unit of a tertiary care rural  hospital between January 2014- June 2014 and followed up till the age of 6 months. Methods:  Infants with birth weight lessthen 1500 g and gestation less then equal to 32 weeks were screened for ROP at per decided schedule. Infants with birthweight greater  than equal to 1500g and gestation  greater than 32 weeks were screened only if they had additional risk factors. Those found to have threshold disease ROP had laser photocoagulation. Post discharge babies were followed up till the age of 6 months. Results: The prevalence of ROP in the 62 infants who were screened was 29%. No ROP was found in infants weighing greater then equal to 1800g or with a gestational age more than 33weeks. Risk factors predisposing to ROP were oxygen administration which was studied with two factors, maximum FIO2 delivered and total duration of oxygen therapy,  abnormal ABGs within 24 hours of birth, H/O seizures, shock and respiratory distress syndrome.  Laser photocoagulation was done in 7  out of the 10 infants having ROP . Some babies  had  post-laser transient  conjunctival redness. Vision in operated babies after 6 months was satisfactory. Conclusion: The prevalence was 29%.Common preterm morbidities are risk factors. Early treatment prevents blindness.

Key words: Laser Photo-Coagulation; High Risk  Follow-up; Retinopathy of Prematurity; Visual Outcome; Risk Factors.