Ophthalmoscopic examination of the premature infant requires binocular indirect ophthalmoscopy, use of an eyelid speculum, and wide pupillary dilatation. Normal and pathologic features unique to the infant eye often are encountered. Familiarity with these features is essential for accurate diagnosis and prevention of unnecessary therapeutic intervention. Supplemental oxygen is the mainstay of supportive therapy for idiopathic respiratory distress syndrome, a common cause for morbidity in premature infants. Arterial oxygen monitoring is essential for survival and for prevention of retrolental fibroplasia, but precise arterial oxygen levels associated with development of retrolental fibroplasia have not been established.