Newborn conjunctivitis
Key points
- Neonatal conjunctivitis is a red eye in a newborn caused by irritation, a blocked tear duct, or infection.
- Conjunctivitis in a newborn may be caused by a blocked tear duct, or by irritation produced by the antibiotic eyedrops given at birth.
- 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.
- Early recognition of infected mothers and good hospital preventive practices have reduced conjunctivitis of the newborn to very low levels.
Alternative names
Neonatal conjunctivitis; Conjunctivitis of the newborn; Ophthalmia neonatorum
Definition
Neonatal 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 may be caused 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.
All of 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 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 viruses 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 (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
- Maternal history of any STD
- Watery, bloody (serosanguineous) drainage from the infant's eyes
- Thick pus-like (purulent) drainage from the infant's eyes
- Swollen, red eyelids
- Tensely swollen eyelids
Signs and tests
- Standard ophthalmologic examination
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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