UNLABELLED Retinopathy of prematurity (ROP) is a significant problem in very low birth weight (VLBW) newborns, patients of the neonatal intensive care units (NICU). The aim of the present investigation is to report the results of our ROP-screening program: 1. Current frequency of ROP and the need for retinal surgery; 2. Main risk factors and the prophylactic possibilities for ROP. STUDY DESIGN This is a retrospective study for 3 years period: 08.'98-07.01. 188 survived premature newborn patients of NICU, "Majchin dom", Sofia, met the criteria for ROP screening. The first eye exam was performed at 3 weeks of age, followed by exams every 2 weeks until complete vascularisation of the retina. RESULTS The incidence of ROP any stage was 11.2% (21 of 188) and 4.2% (8) for stage > or = 3. The mean birth weight of the ROP (+) group was 982 g, the mean gestational age (g.a.)--27.9 g.w., comparing with 1258 g and 30.9 g.w. respectively of the ROP(-) group (p < 0.05). ROP stage > or = 3 was diagnosed as a rule among the newborns with birth weight < 1000 g 14.6% (7 of 48) and g.a. < 28 g.w. (6 of 41). Seven children have undergone successful retinal surgery. The children of ROP(+) group needed significantly longer mechanical ventilation and supplemental O2, they developed more often bronchopulmonary dysplasia and severe grade III-IV IVH, the percent of neonatal sepsis and the need of blood transfusions in the first month was greater too. CONCLUSION The frequency and severity of ROP in our study is relatively low and that depends on the strict monitoring of the intensive cares. Main risk factors are extremely low birth weight and gestational age; severe RDS with longer duration of mechanical ventilation and supplemental oxygen. Grade III-IV IVH and neonatal sepsis are often a parallel finding with severe ROP. Other risk factors are the greater number of blood transfusions and the developing of chronic lung disease.