Conjunctivitis is caused by bacteria, viruses, or a reaction to chemicals.
Symptoms vary but may include inflammation of and a discharge from the eyes.
The diagnosis is typically based on the appearance of the eyes.
The infection may be prevented by drops or ointments that are put in the eyes after birth.
Antibiotics and antibiotic ointments are given to treat the infection.
An Inside Look at the Eye
(See also Overview of Infections in Newborns Overview of Infections in Newborns Infections occur at all ages but are a great cause for concern in newborns because newborns, especially premature ones, have an underdeveloped immune system and are more susceptible to infection... read more and Infectious Conjunctivitis Infectious Conjunctivitis Infectious conjunctivitis is inflammation of the conjunctiva usually caused by viruses or bacteria. Bacteria and viruses can infect the conjunctiva. Redness and tearing or discharge are common... read more .)
Causes of Conjunctivitis in Newborns
Conjunctivitis in newborns can be caused by an infection or by a reaction to chemicals put into the eyes (called chemical conjunctivitis). An infection can be caused by bacteria or viruses.
If certain bacteria are present in the mother's vagina, they can be passed to the newborn during delivery. Such bacteria include Chlamydia Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted infections of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect... read more , Streptococcus pneumoniae Streptococcal Infections Streptococcal infections are caused by any one of several species of Streptococcus. These gram-positive, sphere-shaped (coccal) bacteria (see figure How Bacteria Shape Up) cause many... read more , Haemophilus influenzae Haemophilus influenzae Infections Haemophilus influenzae are gram-negative bacteria that can cause infection in the respiratory tract, which can spread to other organs. Infection is spread through sneezing, coughing,... read more , Neisseria gonorrhoeae Gonorrhea Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover... read more , and others.
Chemical conjunctivitis is a reaction to the eye drops that newborns receive to prevent infection.
Symptoms of Conjunctivitis in Newborns
Symptoms of conjunctivitis may vary depending on the cause of the infection.
Conjunctivitis caused by chlamydia usually begins 5 to 14 days after delivery but sometimes as late as 6 weeks after. Newborns have swollen eyelids and a watery discharge from the eyes that contains increasing amounts of pus. The infection can sometimes be severe.
Conjunctivitis caused by gonorrhea usually begins 2 to 5 days after delivery. Newborns have severe inflammation of the eyelids and discharge of pus from the eyes. Without treatment, blindness may occur.
Conjunctivitis caused by chemicals, such as eye drops, usually begins within 6 to 8 hours after the drops are put in and goes away by itself within 2 to 4 days.
Conjunctivitis caused by other bacteria begins from 4 days up to several weeks after delivery.
Diagnosis of Conjunctivitis in Newborns
Testing of the eye discharge
Doctors evaluate the newborn's symptoms and appearance of the eyes.
Samples of eye discharge are sent to a laboratory to identify the infecting organism.
Prevention of Conjunctivitis in Newborns
In the United States, erythromycin ointment or drops are routinely put into each of the newborn's eyes after delivery to prevent conjunctivitis caused by Neisseria gonorrhoeae. In other countries, silver nitrate, tetracycline, or povidone iodine also may be used. Except for povidone iodine, these drugs do not prevent conjunctivitis caused by Chlamydia.
Newborns of women who have untreated gonorrhea should receive a single injection of the antibiotic ceftriaxone even if they are not yet ill.
Treatment of Conjunctivitis in Newborns
For conjunctivitis caused by Chlamydia, the antibiotic erythromycin or azithromycin is given by mouth.
For conjunctivitis caused by Neisseria gonorrhoeae, newborns are hospitalized and given the antibiotic ceftriaxone or cefotaxime by vein or injection.
For conjunctivitis caused by other bacteria, ointments containing polymyxin plus bacitracin, erythromycin, or tetracycline are applied.