Ophthalmia Neonatorum

Neonatal conjunctivitis, also known as ophthalmia neonatorum, presents during the first month of life.

Causes

Specific common types of bacterial infection are:

1- Gonorrhoeal infection – typically, 2-5 days after birth but it may occur later

2- Chlamydial infection – 5-12 days after birth (some report up to 28 days after birth): unilateral/bilateral watery discharge which becomes copious and purulent later on. There may be associated preseptal cellulitis The eyes are usually less inflamed than in the case of gonococcal infection.

Clinical features

Purulent, mucopurulent, or mucoid discharge from one or both eyes within the first month of life.

Conjunctiva and lid swelling.

Red eyes

This may be associated with systemic infection.

Management

Azithromycin/erythromycin if Chlymydia suspected

Ceftriaxone 50 mg/kg/dose (2g) iv 12H if gonorrhoea  suspected — Needs hospitalization

In summary, for a GP seeing a baby under the age of 1 month with sticky eyes: if the eyes are red as well as sticky plus if any of the other concerning features are present – system features such as fever, surrounding cellulitis, refer for specialist advice immediately. If there are no concerning features then take swabs for bacterial culture, gonorrhoea, and chlamydia.