Ophthalmia Neonatrum (ON)

Clinical Description

Conjunctivitis developing within the first month after birth because of infection transmitted from mother to infant during delivery.

Signs and Symptoms

• Chlamydia ON
• Most common. Occurs 5 - 14 days after birth. May be unilateral or bilateral.
• Red eye, watery discharge, lid oedema, pseudo membranes (depending on severity)
• Gonococcal ON
• Occurs 2 - 7 days after birth. Almost always bilateral.
• Severe and copious purulent discharge, red eyes, marked lid oedema and chemosis,
• Herpetic ON
• Occurs 1 - 14 days after birth
• Periocular vesicles, lid oedema, moderate redness of the eyes.

Treatment

• Ophthalmia neonatorum may have both ocular and systemic complications; therefore, it should be treated systemically.
• Chlamydia ON: Erythromycin suspension 50mg/kg/day 6 hourly for 14 days with Tetracycline eye ointment every 6hrs
• Gonococcal ON: Ceftriaxone 50mg/kg/24hr (maximum 125mg) IV or IM with tetracycline eye ointment every 6hrs for 2 weeks. Frequent eye irrigation with sterile isotonic saline is recommended as adjunct therapy.
• Herpetic ON: Acyclovir 45-60mg/kg in 3 divided doses for 14 days and topical Acyclovir 5 times daily

PROPHYLAXIS

• Given within 24 hours after birth as a single dose.
• Povidone-iodine 2.5% or Tetracycline 1% ointment
• Single dose of ceftriaxone 50mg/kg I or IV should be given to infants born to mothers with untreated gonococcal infection.