Neonatal conjunctivitis

Alternative names:

conjunctivitis of the newborn; newborn conjunctivitis; ophthalmia neonatorum

Definition:

An eye infection of the newborn acquired during passage through the birth canal.

Causes, incidence, and risk factors:

Many organisms can cause infection in the eyes of newborn infants but the most common birth-related bacterial infections with the potential to cause eye damaging are gonorrhea (Neisseria gonorrhea) and Chlamydia (Chlamydia trachomatis). Herpes is a virus that can cause neonatal conjunctivitis (eye infection) and severe eye damage. It may also be acquired during passage through the birth canal, however the incidence of herpes conjunctivitis is less than the others.

These organisms are generally picked up by the expectant mother as a sexually-transmitted disease (STD). Chlamydia may be the most common STD in the United States today (Note: gonorrhea is the most common reported bacterial infection) and Chlamydial conjunctivitis in the newborn is seen 10 times as frequently as gonorrheal conjunctivitis.

The mother may be without symptoms (asymptomatic) at the time of delivery yet still harbor bacteria or virus capable of causing 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. Gonorrhea may cause perforation of the cornea and very significant destruction of the deeper eye structures. Chlamydia is somewhat less destructive.

Because of the significance of neonatal conjunctivitis, all hospitals routinely use silver nitrate or antibiotic drops in the newborn's eyes to prevent disease. Silver nitrate is no longer commonly used and has been mostly replaced by antibiotic eye drops.