OPHTHALMIA NEONATORUM

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    • OPHTHALMIA NEONATORUM
      • bilateral inflammation of the conjunctiva
      • occur in an infant
      • any discharge or even watering from the eyes in the first week of life should arouse suspicion of ophthalmia neonatorum, as tears are not formed till then.
      • During birth is most common mode of infection from the infected birth canal especially when the child is born with face presentation or with forceps.
    • Causative agents
      • Chemical conjunctivitis  caused by silver nitrate or antibiotics used for prophylaxis.
      • Gonococcal
      • Staphylococcus aureus, Streptococcus haemolyticus, and Streptococcus pneumoniae.
      • Neonatal inclusion conjunctivitis caused by serotypes D to K of Chlamydia trachomatis is the commonest cause of ophthalmia neonatorum in developed countries.(MCQ)
      • Herpes simplex ophthalmia neonatorum caused by herpes simplex-II virus.
    • Symptoms and signs
      • Pain and tenderness in the eyeball.
      • Conjunctival discharge.
        • It is purulent in gonococcal ophthalmia neonatorum
        • mucoid or mucopurulent in other bacterial cases and neonatal inclusion conjunctivitis.
      • Lids
        • usually swollen in infants born to mothers with untreated gonococcal infection.
    • Treatment
      • Postnatal Prophylactic measures include :
        • Use of either 1 percent tetracycline ointment or 0.5 percent erythromycin ointment or 1 percent silver nitrate solution (Crede’s method) into the eyes of the babies immediately after birth.
      • Curative treatment.
        • Chemical ophthalmia neonatorum
          • a self-limiting condition, and does not require any treatment.
        • Gonococcal ophthalmia
          • Topical therapy should include :
            • Saline lavage hourly till the discharge is eliminated.
            • Bacitracin eye ointment
            • penicillin drops
            • If cornea is involved then atropine sulphate ointment should be applied.
          • Systemic therapy for 7 days
            • Ceftriaxone
            • Cefotaxime
            • Ciprofloxacin
            • crystalline benzyl penicillin
        • Neonatal inclusion conjunctivitis
          • topical
            • tetracycline 1 per cent
            • erythromycin 0.5 per cent
          • systemic erythromycin
            • Both parents should also be treated with systemic erythromycin.


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