NICU

Conjunctivitis in Newborns

Conjunctivitis in Newborns, Neonatal Conjunctivitis, Ophthalmia Neonatorum, Eye Discharge in Newborns

Chemical Conjunctivitis (most common)
1. Typically a reaction to prophylactic Topical Antibiotics applied at birth (less common with Erythromycin than Silver Nitrate)
2. Mild palpebral edema and clear, sterile Eye Discharge
3. Onset <24-36 hours within eye prophylaxis at birth
4. Resolves within 48 hours of birth
Gonorrheal Conjunctivitis
1. See Gonorrhea
2. Onset typically within 2-4 days of life (up to 7 days of life)
3. Severe bilateral involvement with lid edema, Chemosis, and purulent exudates
4. Risk of Corneal Ulcer and Corneal perforation
Chlamydia Conjunctivitis
1. Onset within 5-14 days of birth (up to 3-4 weeks)
2. Initial mild watery discharge
3. Progresses to diffuse swelling and Chemosis with copious and purulent discharge
Herpes Simplex Virus Conjunctivitis (HSV Conjunctivitis)
1. Onset within 6-14 days of birth
2. Up to 20% of HSV infected infants are affected
3. Corneal Herpetic Dendrites on Fluorescein stain
4. Risk of disseminated Herpes Simplex Virus
5. Risk of Vision Loss as well as Keratitis, Uveitis, Cataracts, chorioretinitis, Optic Neuritis
Other causes
1. Moraxella catarrhalis Conjunctivitis
2. Adenovirus

Dacryostenosis (blocked tear ducts)
1. Common in infants, presenting with a build-up of yellow, sticky, non-purulent secretions
2. Treated with warm compresses to the eye