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Alternative namesNewborn conjunctivitis; Conjunctivitis of the newborn; Ophthalmia neonatorum
DefinitionNeonatal conjunctivitis is a red eye in a newborn caused by irritation, a blocked tear duct, or infection.
Causes, incidence, and risk factors
Conjunctivitis in a newborn can be caused simply by a blocked tear duct or by irritation produced by the antibiotic eyedrops given at birth. However, if it is caused by an infection, it can be very serious.
Many organisms can cause infection in the eyes of newborn infants. The most common bacterial infections with potential to cause serious eye damage are gonorrhea (Neisseria gonorrhea) and Chlamydia (Chlamydia trachomatis), which can be passed from mother to child during birth.
The viruses that cause genital and oral herpes can also cause neonatal conjunctivitis and severe eye damage. These viruses may also be acquired during passage through the birth canal, however herpes conjunctivitis is less common than those caused by gonorrhea and Chlamydia.
Gonorrhea may cause perforation of the cornea and very significant destruction of the deeper eye structures. Chlamydia is somewhat less destructive.
Signs and tests
Topical antibiotic eye drops and ointments, oral antibiotics, and intravenous antibiotics are all used depending on the severity of the infection and the organism responsible for it.
Occasionally, topical and oral (or topical and intravenous) routes may be used simultaneously. Irrigation of the eye with normal saline is done to remove the purulent drainage that accumulates.
If the conjunctivitis is caused by a blocked tear duct, gentle warm massage between the eye and nasal area may help. If it is not cleared by one year of age, surgery may be required.
Irritated eyes caused by the eye drops given at birth should resolve on their own.
Expectations (prognosis)Early recognition of infected mothers and good hospital preventive practices have reduced conjunctivitis of the newborn to very low levels. Infants who do develop conjunctivitis and are quickly treated generally have good outcomes.
Calling your health care providerTalk to your health care provider if you have given birth (or expect to give birth) to a baby in a setting where antibiotic or silver nitrate drops are not routinely placed in the infant's eyes (for example, an unsupervised birth at home). This is especially important if you have had, or are at risk for, any sexually-transmitted disease.
Treatment of the pregnant mother for sexually-transmitted diseases will prevent conjunctivitis in the neonate . If the mother's infection has not been recognized, keep in mind that prophylactic eye drops put into the infant's eyes immediately after birth help prevent many infections, and these drops are used routinely for all births.
A cesearean section is recommended when the mother has active herpes lesions at the time of delivery. Antibiotics, given intravenously, may be given to infants delivered of mothers with untreated gonorrhea . However, antibiotic eye drops may not prevent Chlamydial conjunctivitis.
Update Date: 7/26/2002Elizabeth Hait, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT