Neonatal conjunctivitis Health Article

Definition

Neonatal conjunctivitis is a red eye in a newborn caused by irritation, a blocked tear duct, or infection.

Alternative Names

Newborn conjunctivitis; Conjunctivitis of the newborn; Ophthalmia neonatorum

Causes, incidence, and risk factors

Conjunctivitis in a newborn may be caused by a blocked tear duct, irritation produced by the antibiotic eyedrops given at birth, or infection. Neonate conjunctivitis that is caused by an infection can be very serious.

Many organisms can cause infection in the eyes of newborn infants. The most common bacterial infections with that can 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. Such viruses may also be passed to the baby during childbirth. However, herpes conjunctivitis is less common than conjunctivitis caused by gonorrhea and chlamydia.

Bacteria that normally live in a woman's vagina, which are not sexually transmitted, can also cause neonatal conjunctivitis.

The mother may be without symptoms (asymptomatic ) at the time of delivery, yet still carry bacteria or viruses that can cause conjunctivitis in the newborn. Infected newborn infants develop drainage from the eyes within 1 day to 2 weeks after birth. The eyelids become puffy, red, and tender.

Because of the significance of neonatal conjunctivitis, all hospitals (most required by state law) routinely use silver nitrate or antibiotic drops, such as erythromycin, in a newborn's eyes to prevent disease. Silver nitrate is no longer commonly used, and has been mostly replaced by antibiotic eye drops.

Symptoms

• Watery, bloody drainage from the infant's eyes
• Thick pus-like drainage from the infant's eyes
• Swollen, red eyelids

Signs and tests

• Standard ophthalmologic examination
• Slit-lamp examination to look for corneal ulceration, perforation, or other changes (called iridocyclitis and inclusion blennorrhea)
• Culture of the drainage from the eye to look for Neisseria gonorrhea and Chlamydia trachomatis