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(Neonatal Conjunctivitis) Dr. Monica Dhiman

Neonatal conjunctivitis is an inflammation of the conjunctiva that occurs during the neonatal period. It is the most common eye infection in newborns. The infection is usually acquired during vaginal delivery and reflects STD prevalence in the community. Common causes include Chlamydia trachomatis, Neisseria gonorrhoeae, and other bacteria. Prophylaxis with erythromycin or silver nitrate eye drops after birth can prevent infection. Complications may include corneal ulceration or perforation if left untreated.

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141 views20 pages

(Neonatal Conjunctivitis) Dr. Monica Dhiman

Neonatal conjunctivitis is an inflammation of the conjunctiva that occurs during the neonatal period. It is the most common eye infection in newborns. The infection is usually acquired during vaginal delivery and reflects STD prevalence in the community. Common causes include Chlamydia trachomatis, Neisseria gonorrhoeae, and other bacteria. Prophylaxis with erythromycin or silver nitrate eye drops after birth can prevent infection. Complications may include corneal ulceration or perforation if left untreated.

Uploaded by

Monica
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NEONATAL

CONJUCTIVITIS

DR. MONICA DHIMAN


M.D. SCHOLAR (1st YEAR)
KAUMARBHRITYA DEPARTMENT
3 DEFINATION

 Conjunctiva inflammation during the


neonatal period.
 Watering of the eyes should create
a suspicion of this as tears are not
formed before 3-4 weeks post
partum
Epidemiology
4

 It’s the most common eye


infection in new borns
 Ophtalmia neonatorum acquired

during vaginal delivery reflects


the prevalence of STD in the
community
Etiology
7

Modes of infection could be:


 Before birth

 During(most common) or

 After birth
8

Source of infection could be:


 Maternal genital tract

 Non sterile towels and clothing,

infected hands
 The environment…
cont…
9

PREDISPOSING FACTORS:
 Premature rupture of membranes

 prolonged labor

 Untreated maternal infections

 Trauma to epithelial barrier

 Prophylaxis (antibiotics, silver

nitrate)
cont…
10

 The causes can be broadly


classified as : Infectious and
Non infectious
11

 Chemical conjunctivitis
 Chlamydia trachomatis

 N. gonorrhoeae

 Systemically it can be
complicated with septicemia and
meningitis
Miscelanious bacteria
16

 Those include – staph. aureus ,


strep. Hemolyticus , strep.
Pneumoneae , pseudomonas
auruginosa , and heamophilus
influenza
 Pseudomonas poses a serious

concern
PREVENTION
19

 Prophylaxis
1. Antenatal : care of mother
2. Natal : hygienic delivery
3. Postnatal : 1% tetracycline, 0.5%
erythromycin or 1% silver nitrate
solution
20

 Maternal screening -The most effective


measure to prevent both gonococcal and
chlamydial infections is to diagnose and
treat these infections in pregnant women
23

 Drops of 0.5% erythromycin or 1% silver


nitrate(Credé’s method of prophylaxis) are
instilled directly into the open eyes at birth
using wax or plastic single-dose containers.
 Saline irrigation after silver nitrate
application is unnecessary

 Tetracycline (1 percent) ophthalmic ointment;


24


Erythromycin ophthalmic ointment
causes less chemical conjunctivitis
than does silver nitrate solution but
silver nitrate is more effective as a
prophylaxis for penicillinase-producing
Neisseria gonorrhoeae than
erythromycin and should be used in
areas where that organism is
prevalent
25

 Asymptomatic infants whose mothers have


untreated gonococcal infection are at high
risk for acquiring infection.
should receive systemic treatment
with a single dose of ceftriaxon
(25 to 50 mg/kg, up to a total dose
of 125 mg, IV or IM) in addition to
topical prophylaxis
26

 A single instillation of povidoneiodine


2.5% solution is effective against the
common pathogens
 diagnosis and treatment of chlamydial
infections in pregnant women is the best
method for preventing chlamydial
disease.
 Infants born to mothers known to have
untreated chlamydial infection are at high
risk for infection; however, prophylactic
antimicrobial treatment is not indicated
27

 Complications include
Ὕ corneal ulceration and perforation,
Ὕ iridocyclitis,
Ὕ anterior synechiae, and
Ὕ rarely panophthal-mitis
Ὕ blindness, and death
31

 Reference
Jack j kaniski and brad bowling,
clinical ophthalmology 7th edition
Up to date 19.3 verison
Nelson textbook of pediatrics 19th
edition Fanaroff and martins neonatal-
perinatal medicine 8th edition
32

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