As neonatal care improves around the world, more premature babies are surviving. That progress is one of modern medicine’s most important achievements, but it also brings a new responsibility: ensuring those infants have the support they need to develop, thrive, and avoid preventable disability.
One of the most urgent concerns is retinopathy of prematurity, a condition that can affect premature infants and remains a leading cause of preventable childhood blindness worldwide. When screening is delayed or unavailable, the consequences can last a lifetime.
In Mongolia, Orbis International and Siloam Vision are helping address that challenge through an AI-assisted screening program at the National Center for Maternal and Child Health neonatal intensive care unit in Ulaanbaatar.
A new challenge emerging from improved neonatal care
For decades, newborn health programs have focused heavily on survival. That priority remains essential, especially for premature infants who often require specialized care in the earliest days of life.
But survival is only the beginning. As more preterm babies live beyond the neonatal period, health systems must also focus on developmental outcomes, disability prevention, and long-term quality of life.
Healthy vision plays a critical role in early childhood development. It supports movement, social interaction, learning, brain development, and independence. When vision loss occurs in infancy, the impact can extend far beyond the eyes.
“As survival improves, investments must also focus on quality, disability prevention and developmental outcomes so that every child has the opportunity not only to survive, but to thrive.”
— Kathleen Sherwin, President & CEO, Orbis International
Why retinopathy of prematurity remains a global concern
Retinopathy of prematurity can develop when abnormal blood vessels grow in the retina of premature infants. Without timely screening, referral, and treatment, the condition can progress and lead to severe vision impairment or blindness.
The challenge is especially significant in regions where neonatal survival is improving but specialist eye care services remain limited or difficult to access. Premature infants often require follow-up screening within narrow time windows, making delays particularly risky.
In countries with large geographic distances and dispersed populations, access becomes even more complicated. Families may live far from tertiary hospitals, and local clinicians may not always have immediate access to pediatric retina specialists.
This is where technology can begin to change the care pathway. In Mongolia, mobile retinal imaging, telemedicine, and AI-assisted review are being combined to support earlier identification of infants at risk.
How AI is supporting vision screening and earlier detection
The program uses smartphone-based retinal imaging systems to capture images from premature infants, including those in remote provinces. Those images can then be reviewed through telemedicine networks connected to specialists at the National Center for Maternal and Child Health.
AI supports the process by helping clinicians identify high-risk cases more quickly and consistently. The technology does not replace clinical decision-making, but it can help ophthalmologists prioritize urgent cases and reduce delays in referral and follow-up.
That distinction matters. The strongest role for AI in this setting is not to remove doctors from the process, but to strengthen the system around them. AI-assisted screening may be especially valuable when specialist resources are limited, distances are large, and early decisions can influence a child’s lifelong vision.
Reaching infants beyond major hospitals
Mongolia’s geography makes this model particularly important. Large distances between communities can make specialist care difficult to access, especially for families with newborns requiring close medical follow-up.
By training doctors in remote provinces to use mobile imaging tools and connecting those images to specialist review, the program helps extend advanced newborn eye care beyond major hospital settings.
The initiative has already supported more than 270 examinations for over 170 newborns, demonstrating how workforce training, telemedicine, and AI-enabled review can work together within maternal and newborn care systems. For families, faster review can mean less uncertainty and earlier action when follow-up is needed. For health systems, it creates a more scalable pathway for identifying vulnerable infants before preventable vision loss occurs.
What Mongolia’s experience could mean for global eye care
The Mongolia program offers a powerful example of how innovation can support public health when it is built around real care gaps. The technology matters, but so does the system around it: trained clinicians, mobile imaging, referral networks, and integration into newborn services.
As more countries improve neonatal survival, the need for stronger retinopathy of prematurity screening will continue growing. Programs like this show how AI and telemedicine may help expand access without waiting for every community to have immediate specialist availability.
The larger lesson is clear. Protecting premature infants means looking beyond survival alone and investing in the care systems that support development, disability prevention, and long-term opportunity. For children at risk of preventable blindness, timely vision screening is not a secondary concern. It is part of giving every child the chance to see, learn, grow, and thrive.
Source: PMNCH
