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Ophthalmia Neonatorum (Newborn Eye Infection)

What Is Ophthalmia Neonatorum?

Ophthalmia neonatorum is a severe eye infection that occurs in newborns within the first 28 days of life.
It presents as eye redness, swelling of the eyelids, and pus-like discharge.
It is a serious condition because, if not treated early, it can lead to corneal damage and permanent blindness.

Causes

The infection is usually caused by organisms acquired during childbirth, especially when the mother has an untreated infection. The major causes include:

a. Neisseria gonorrhoeae
• Causes the most rapid and severe form.
• Symptoms usually appear within 2–5 days after birth.
• Can cause corneal ulceration and blindness quickly if untreated.

b. Chlamydia trachomatis
• Most common cause worldwide.
• Symptoms appear 5–14 days after birth.
• May accompany pneumonia in infants.

c. Other Causes
• Staphylococcus aureus
• Streptococcus species
• Herpes simplex virus (HSV) — can be life-threatening
• Chemical irritation from antiseptics (rare nowadays)

How It Happens (Pathophysiology)

During vaginal delivery, if the mother has an untreated sexually transmitted infection, the baby’s eyes become exposed to the organisms.
These pathogens multiply rapidly in the conjunctiva, causing:
• Inflammation
• Swelling of the eyelids
• Pus production
• Potential corneal damage

Gonococcal infection is particularly aggressive, destroying eye tissue within hours if not managed promptly.

Signs and Symptoms

Newborns with ophthalmia neonatorum may present with:
• Red eyes
• Swollen, puffy eyelids
• Thick yellow or green discharge
• Difficulty opening eyelids
• Irritable baby due to discomfort

The timing of onset helps identify the cause:
• 2–5 days → Likely gonorrhea
• 5–14 days → Likely chlamydia
• Immediate redness → Could be chemical irritation

Treatment

Treatment depends on the cause, but should start immediately,don’t wait for lab results in severe cases.

a. Gonococcal Infection
• IV or IM ceftriaxone
• Clean eyes with warm saline frequently
• Treat mother and her partner

b. Chlamydial Infection
• Oral erythromycin or azithromycin
• Topical treatment alone is not enough
• Treat mother and partner

c. Other Bacterial Causes
• Topical antibiotics such as tetracycline or erythromycin ointment

d. Herpes Infection
• IV acyclovir urgently
• Manage as a medical emergency

Prevention

This is the most important aspect.

a. Antenatal Screening
• Pregnant women should be screened and treated for STIs early in pregnancy.

b. Good Maternal Hygiene
• Ensure healthy vaginal environment before delivery.

c. Routine Newborn Eye Prophylaxis

Most countries apply antibiotic ointment immediately after birth to prevent infection.
Common prophylaxis includes:
• Tetracycline eye ointment
• Erythromycin eye ointment

d. Proper Delivery Practices
• Clean delivery environment
• Avoid harmful substances or traditional eye applications

Complications (If untreated)
• Corneal ulceration
• Perforation of the cornea
• Permanent blindness
• Spread of infection to the bloodstream (gonococcal sepsis)


FB: please this is solely for educational purposes

Mothers how do you care for your babies umbilical cord from birth?