Definition

Newborn conjunctivitis is an inflammation of the surface or covering of the eye. It generally occurs in the first month of life.

The earlier newborn conjunctivitis is identified, the better the outcomes.

Causes

The cause of the conjunctivitis may be an irritation in the eye or a blocked tear duct. In some cases the irritation may be from the antibiotic given after delivery.

Bacteria can also cause an infection in the eye. The most common types of bacteria that cause infection in the infant’s eye come from the mother’s birth canal, and are passed to the infant during delivery. These infections can include:

• Sexually transmitted diseases (STDs)—The most common bacteria passed to infants during delivery are due to STDs from the mother’s birth canal. If untreated, many of these infections can cause serious damage to the infant’s eye. STDs that can cause eye damage include:
  • Chlamydia
  • Gonorrhea
  • The virus that causes oral and genital herpes
• Skin bacteria
• Bacteria from the mother’s gastrointestinal tract

Risk Factors

The biggest risk factor for developing newborn conjunctivitis is a maternal infection or STD at the time of delivery. The mother may not have any symptoms during delivery and still be able to transmit the infection. If you are pregnant, it is important to discuss any STDs that you have or had in the past. You and your doctor can develop a plan to protect your baby from infections during delivery.

Symptoms

The most common symptoms are redness and swelling of the conjunctiva in the newborn. Newborn conjunctivitis may also cause:

• Drainage and discharge from the eye; it may be watery or thick and pus-like
• Swollen eyelids

Diagnosis

If your baby’s pediatrician suspects newborn conjunctivitis, an eye examination will be done. The doctor will look at your baby’s eyes to check for anything that may be irritating the eye, and to see if any damage has occurred. The doctor may also want to take a sample of any discharge to determine what type of bacteria or virus is causing the infection.

Treatment

The treatment of newborn conjunctivitis depends on the cause:

Prevention

Since the potential for serious eye damage to the infant is so great, it is standard treatment in US hospitals to give infants antibiotic eye drops or ointment right after delivery. This helps prevent the development of an eye infection even if the mother shows no symptoms of infection. Prevention methods for newborn conjunctivitis include:

• Antibiotic eye ointment given to the infant after birth
• Treating the mother for any STDs prior to labor and delivery
• A cesarean section for mothers with active genital herpes lesions

An open, honest relationship with your doctor is important during your pregnancy. Disclosure of your full medical history can help protect your baby from infection.

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca/

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Ophthalmia neonatorum. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated February 3, 2012. Accessed February 19, 2013.

RE Behrman, RM Kliegman, HB Jenson. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, PA: Saunders; 2004.

RM Kleigman, RE Behrman, HB Jenson, BF Stanton. Nelson Textbook of Pediatrics. 18th Edition. Eds. Saunders Publishers, Philadelphia PA, 2007.

Rubenstein JB, Jick SL. Disorders of the conjunctiva and limbus. Ophthalmology. 2nd ed. Mosby: New York; 2004.