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Ophthalmia Neonatorum
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Ophthalmia Neonatorum Overview
Ophthalmia neonatorum (newborn conjunctivitis, neonatal conjunctivitis) is conjunctivitis (inflammation of the surface or covering of the eye because of infectious or non-infectious causes) that occurs in the newborn. Any eye infection that occurs in the first month of a baby’s life can be classified as ophthalmia neonatorum. While an infection has the potential to damage the delicate eye of an infant, there are a number of ways these infections can be prevented. Additionally, effective treatment is available for infants that do develop an eye infection.
Symptoms
The most common is redness and swelling of the conjunctiva in the newborn. Some of the other symptoms of ophthalmia neonatorum include drainage and discharge from the eye that may be watery or thick and pus-like; swollen eyelids.
Causes
The cause of the conjunctivitis may be simply an irritation in the eye, or a blocked tear duct. However, bacteria can also cause an infection in the eye. The most common types of bacteria that cause infection in the infant’s eye come from the mother’s birth canal, and are passed to the infant during delivery. The most common bacteria passed to infants during delivery are due to Sexually Transmitted Diseases (STDs) from the mother’s birth canal. If untreated, many of these infections can cause serious damage to the infant’s eye. STDs that can cause eye damage include chlamydia, gonorrhea, the virus that causes oral and genital herpes, skin bacteria such as Staphylococcus aureus, and bacteria from the mother’s gastrointestinal tract, such as Pseudomonas
Diagnosis
Diagnosis is based on eye examination. A sample of any discharge can be tested to determine what type of bacteria or virus is causing the infection.
Treatment
Since the potential for serious eye damage to the infant is so great, it is standard treatment to give infants antibiotic eye drops or ointment immediately following delivery. This helps prevent the development of an eye infection even if the mother shows no symptoms of infection. In cases where conjunctivitis does develop, the treatment of ophthalmia neonatorum depends on the cause.
Prevention
The best prevention of ophthalmia neonatorum is treatment of any sexually transmitted diseases in the mother prior to labor and delivery.
- In most cases, effective treatment of the mother before the time of delivery can prevent the transmission of infection to the newborn.
- For mothers with active genital herpes lesions at the time of delivery, a cesarean section can prevent the infant from getting the infection.
An open, honest relationship with your doctor is important during your pregnancy. Disclosure of your full medical history can help protect your baby from infection
Complications
If untreated, peripheral corneal ulceration may occur in N gonorrhoea infection and rapidly progress to corneal perforation. When unrecognized and not immediately treated, Pseudomonas infection may lead to endophthalmitis and subsequent death.
Risks
The biggest risk factor for developing ophthalmia neonatorum is a maternal infection or STD at the time of delivery. Unfortunately, with some infections, the mother may not have any symptoms during delivery and still be able to transmit the infection.