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ophthalmia%20neonatorum
OPHTHALMIA NEONATORUM
Treatment Guideline Chart
Ophthalmia neonatorum is conjunctivitis occurring in a newborn during the first month of life.
It is also called neonatal conjunctivitis.
Organisms causing neonatal conjunctivitis are usually acquired from the infected birth canal of the mother during vaginal delivery, though some may acquire the infection from their immediate surroundings.
It is one of the leading cause of blindness in infants via corneal ulceration and subsequent opacification or perforation and endophthalmitis.

Ophthalmia%20neonatorum Signs and Symptoms

Introduction

  • Also called neonatal conjunctivitis
  • One of the leading cause of blindness in infants via corneal ulceration & subsequent opacification or perforation & endophthalmitis
    • Pneumonia & otitis media are reported in some of the newborn w/ Chlamydia conjunctivitis

Definition

  • Conjunctivitis occuring in a newborn during the first month of life

Etiology

  • Organisms causing neonatal conjunctivitis are usually acquired from the infected birth canal of the mother during vaginal delivery, though some may acquire the infection from their immediate surroundings
Other bacterial causes of neonatal conjunctivitis
  • Bacteria may be transmitted to the infant after birth through air w/ association w/ obstructed nasolacrimal duct
  • Gram positive organisms:
    • Staphylococcus aureus
    • Streptococcus viridians
    • Streptococcus pneumoniae
    • Staphylococcus epidermidis
  • Gram negative organisms:
    • Escherichia coli
    • Haemophilus sp.
    • Enterobacter sp.
    • Klebsiella pneumonia
    • Proteus sp.
    • Serratia marcescens
    • Pseudomonas sp., rarely occur but may cause corneal perforation, blindness & death
  • Time of onset: 2-5 days postpartum
  • Clinical presentation:
    • Eyelid edema
    • Conjunctival injection w/ discharge
    • Chemosis
  • Milder course w/o corneal & systemic involvement
Viral neonatal conjunctivitis
  • Herpes simplex (HSV) virus type 2 can rarely cause neonatal conjunctivitis
  • Time of onset: 3-15 days postpartum
  • Clinical presentation:
    • Vesicular skin lesions of the lid or lid margin
    • Non-specific lid edema
    • Moderate conjunctival injection
    • Non-purulent serosanguinous discharge
    • True conjunctival membranes
    • Corneal geographic or micro-dendritic epithelial keratitis different from the typical adult herpetic dendrites

Signs and Symptoms

  • Eyelid & palpebral conjunctiva erythema & edema
  • Purulent eye discharge

Risk Factors

  • Inadequate or no prenatal care
  • Maternal infections (especially sexually transmitted diseases) before & during pregnancy
  • Exposure of the infant to infectious organisms
  • Inadequacy of ocular prophylaxis immediately after birth
  • Organisms harboring in the mother’s birth canal
  • Increased shedding of organisms in the vaginal tract of the mother during the last trimester
  • Ocular trauma during delivery
  • Premature rupture of membranes
  • Prolonged labor
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