What is Neonatal Conjunctivitis?
Neonatal conjunctivitis is a red eye in a newborn caused by irritation, a blocked tear duct, or infection. The mother may be without symptoms (asymptomatic) at the time of delivery, yet still carry bacteria or viruses that can cause conjunctivitis in the newborn.
Symptoms
- Watery, bloody drainage from the infant's eyes
- Thick pus-like drainage from the infant's eyes
- Swollen, red eyelids
Diagnosis
- Standard ophthalmologic examination
- Slit-lamp examination to look for corneal ulceration, perforation, or other changes
- Culture of the drainage from the eye to look for Neisseria gonorrhea and Chlamydia trachomatis
Treatment
- Topical antibiotic eye drops and ointments, oral antibiotics, and intravenous antibiotics are all used depending on the severity of the infection and the organism responsible for it.
- Occasionally, topical and oral (or topical and intravenous) routes may be used simultaneously. Irrigation of the eye with normal saline is done to remove the purulent drainage that accumulates.
- If the conjunctivitis is caused by a blocked tear duct, gentle warm massage between the eye and nasal area may help. If it is not cleared by one year of age, surgery may be required.
- Eye irritation caused by the eye drops given at birth should resolve on its own.
Prognosis
Early recognition of infected mothers and good hospital preventive practices have reduced conjunctivitis of the newborn to very low levels. Infants who do develop conjunctivitis and are quickly treated generally have good outcomes.
Neonatal Conjunctivitis Treatment at Hopkins Children’s is managed by the Divisions of Neonatal-Perinatal Medicine and Ophthalmology.