Opthalmology

Unit 5: Children & Squint

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1. Conjunctivitis of the newborn

Introduction

  • Neonatal conjunctivitis (Ophthalmia Neonatorum) is common and occurs in babies less than 4 weeks old.

  • It can be acquired during delivery if mother has a vaginal infection or acquired from the birth environment or birthing staff.

Newborn with gonococcal ophthalmia neonatorum caused by a maternally transmitted gonococcal infection.

Source: Public Health Image Library (PHIL). Content Providers(s): CDC / J. Pledger.

Signs

  • Injected hyperaemic conjunctiva
  • Lid swelling
  • Discharge
  • Can be bilateral or unilateral
  • Check cornea for ulceration

Consider the following infective agents:

The differential diagnosis also includes nasolacrimal duct blockage

Treatment

  • If no history of maternal vaginal infection, then treat with lid hygiene and topical broad spectrum antibiotic (eg chloramphenicol eye drops qds for 1 week)
  • Conjunctival swab to microbiology
  • History of maternal infection; refer to ophthalmology
  • Follow up once weekly until resolved