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OPHTHALMIA

NEONATORUM

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Neonatal conjunctivitis, also known

as ophthalmia neonatorum, is a form of

bacterial conjunctivitis contracted by newborns

during delivery.

The baby's eyes are contaminated during

passage through the birth canal from a mother

infected with eitherNeisseriagonorrhoeae orChlamydia trachomatis.

Ophthalmic ointment containing

0.5% erythromycin is typically applied to thenewborn's eyes within 1 hour of birth as

prophylaxis against gonococcal ophthalmia.

If left untreated it can cause blindness.

http://en.wikipedia.org/wiki/Conjunctivitishttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Neisseria_gonorrhoeaehttp://en.wikipedia.org/wiki/Neisseria_gonorrhoeaehttp://en.wikipedia.org/wiki/Chlamydia_trachomatishttp://en.wikipedia.org/wiki/Erythromycinhttp://en.wikipedia.org/wiki/Erythromycinhttp://en.wikipedia.org/wiki/Chlamydia_trachomatishttp://en.wikipedia.org/wiki/Neisseria_gonorrhoeaehttp://en.wikipedia.org/wiki/Neisseria_gonorrhoeaehttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Conjunctivitis

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Causes, incidence, and risk factors

Neonatal conjunctivitis is most commonly causedby:

A blocked tear duct

Infection by bacteria or viruses, or irritation fromantibiotic eyedrops containing silver nitrate

(these are rarely used anymore)

Bacteria that normally live in a woman's vaginamay cause a milder form of neonatal

conjunctivitis. However, an infection with other

bacteria or viruses can be very serious.

http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A001016/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A001016/

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Causes, incidence, and risk factors

The most common bacteria that can cause seriouseye damage are gonorrhea and chlamydia, which can

be passed from mother to child during birth.

The viruses that cause genital and oral herpes may

also be passed to the baby during childbirth, and maylead to severe eye damage. Herpes eye infections

are less common than those caused by gonorrhea

and chlamydia.

The mother may not have symptoms at the time of

delivery. Yet she still may carry bacteria or viruses

that can cause conjunctivitis in the newborn.

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Symptoms

Infected newborn infants develop drainage

from the eyes within 1 day to 2 weeks

after birth. The eyelids become puffy, red, and

tender.

There may be watery, bloody, or thickpus-like drainage from the infant's eyes.

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Signs and tests

The health care provider will perform an

eye exam on the baby. If the eye does not

appear normal, the following tests may bedone:

Culture of the drainage from the eye to

look for bacteria or viruses Slit-lamp examination to look for damage

to the surface of the eyeball

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Treatment

Eye irritation that is caused by the eye drops given at birthshould go away on its own.

For a blocked tear duct, gentle warm massage between the

eye and nasal area may help. This is usually tried before

starting antibiotics. If a blocked tear duct has not cleared up by

the time the baby is a year old, surgery may be needed.

Antibiotics are often needed for eye infections caused by

bacteria. Eye drops and ointments may also be used. Salt

water eye drops may be used to remove sticky yellow

drainage.

Special antiviral eye drops or ointments are used for herpes

infections of the eye.

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Expectations (prognosis)

Early diagnosis of infected mothers

and good preventive practices at

hospitals have made this problemmuch less common in newborns.

Quick diagnosis and treatment

usually leads to good outcomes.

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Complications

Blindness

Inflammation of the iris

Scar or hole in the cornea--the clear

structure that is over the colored part

of the eye (the iris)

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Prevention

Treating a pregnant woman for sexually transmitted

diseases will prevent conjunctivitis caused by these

infections in her newborn.

Putting eye drops into all infants' eyes in the deliveryroom right after birth can help prevent many

infections. (Most states have laws requiring this

treatment.)

When a mother has active herpes sores at the time of

delivery, a cesarean section is recommended to

prevent serious illness in the baby.

http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A002911/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A002911/