What is Ophthalmia Neonatorum?
Ophthalmia Neonatorum is a severe eye infection that occurs in newborns, typically within the first 28 days of life. It causes inflammation and discharge from the eyes and, if left untreated, can lead to blindness. The infection is often acquired during delivery when the baby passes through the birth canal of a mother infected with certain bacteria or viruses.
This condition is considered a medical emergency and requires prompt diagnosis and treatment to prevent complications.
What Causes Ophthalmia Neonatorum?
The most common causes are infectious agents that the baby is exposed to during childbirth. These include:
- Neisseria gonorrhoeae (gonorrhea)
- Chlamydia trachomatis (chlamydia)
- Herpes simplex virus (HSV)
- Other bacteria (e.g., Staphylococcus, Streptococcus, E. coli)
Non-infectious causes, such as chemical irritation from eye drops (used for prevention), can also cause a mild form of conjunctivitis.
Common Risk Factors
- Mother with untreated sexually transmitted infections (STIs)
- Premature birth (weakened immune defenses)
- Prolonged rupture of membranes before birth
- Vaginal delivery in mothers with active genital herpes or infections
- Inadequate prenatal care
What Are the Symptoms of Ophthalmia Neonatorum?
Symptoms usually begin within the first 1–2 weeks of life and may include:
- Redness and swelling of the eyelids
- Thick yellow or green discharge from one or both eyes
- Crusting around the eyes
- Pain or discomfort (indicated by irritability or excessive crying)
- Difficulty opening the eyes due to swelling or discharge
- Cloudiness or ulceration of the cornea (in severe cases)
How is Ophthalmia Neonatorum Diagnosed?
Diagnosis involves:
Clinical Examination
A pediatrician or eye specialist examines the baby’s eyes for signs of infection.
Laboratory Tests
- Swabs of eye discharge are taken to identify the specific organism through culture or PCR testing.
- Blood tests may be done if systemic infection is suspected.
- STI screening in the mother may also be necessary.
How is Ophthalmia Neonatorum Treated?
Treatment depends on the cause:
Bacterial Infections (Gonorrhea, Chlamydia)
- Gonorrhea: Treated with intravenous or intramuscular antibiotics such as ceftriaxone.
- Chlamydia: Treated with oral antibiotics like erythromycin.
- Eye irrigation with saline may be used to clear discharge.
Viral Infections (Herpes Simplex Virus)
- Treated with antiviral medications such as acyclovir.
- Hospitalization may be required for close monitoring.
Chemical Conjunctivitis
- Usually mild and self-limiting
- Managed by stopping the irritant and providing supportive care
Supportive Measures
- Gentle cleaning of the eyes with sterile gauze
- Monitoring for complications such as corneal damage
What is the Prognosis for Ophthalmia Neonatorum?
With early and appropriate treatment, most infants recover fully without long-term effects. However, delayed treatment can lead to serious complications, including:
- Corneal ulceration
- Scarring
- Permanent vision loss or blindness
- Systemic infections (in severe cases)
Prompt diagnosis and medical attention are critical for a good outcome.
When Should I Contact a Doctor?
Seek immediate medical care if a newborn develops:
- Red or swollen eyes
- Any eye discharge
- Difficulty opening the eyes
- Signs of discomfort or crying when the eyes are touched
- Fever or other symptoms of infection
Frequently Asked Questions (FAQs)
Can Ophthalmia Neonatorum be prevented?
Yes. Newborns are often given preventive antibiotic eye drops (such as erythromycin) shortly after birth. Prenatal screening and treatment of maternal STIs are also essential.
Is it contagious?
Yes, especially if caused by bacterial or viral infections. Proper hygiene and early treatment reduce the risk of spreading the infection.
Does every baby need eye drops after birth?
In many countries, it is standard protocol to give newborns prophylactic eye drops to prevent Ophthalmia Neonatorum, especially in areas where STI rates are high.