Ophthalmia neonatorum
Background
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Ophthalmia neonatorum = any conjunctivitis within the first month of life
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also known as neonatal conjunctivitis​
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Caused by infection of infant's eye during delivery
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Common – most common infection in neonates
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Can cause blindness
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Requires prompt diagnosis and management to prevent sight-threatening complications
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Causes
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Commonly from birth canal
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Timing of onset suggestive of causative organism
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Week 1: Neisseria gonorrhoeae
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Week 1-2: Herpes simplex (typically HSV2)
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Week 1-3: chlamydia trachomatis
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Can also be caused by Staphylococcus species, and as a reaction to chemical drops into the eye
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Presentation
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presents as conjunctivitis
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discharge from eye
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Management
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Identify organisms from cultures – conjunctival swabs
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Systemic antibiotics e.g. erythromycin PO
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Topical antibiotics
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Prevention: povidone-iodine eyedrops can prevent Neisseria gonorrhoeae & Chlamydia trachomatis infections developing
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If caused by STI - notification and treating of mother via GUM services, partner notification
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Complications
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Neisseria gonorrhoeae can progress to corneal perforation and endophthalmitis
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Chlamydia can cause keratitis and permanent corneal scarring
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Real risk of blindness, especially if not promptly identified/ treated, must be managed by MDT: paediatricians, ophthalmologists, microbiologists
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References:
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James, B., Bron, A. J. and Parulekar, M. V. (2016) Lecture Notes Ophthalmology. 12th edn. Nashville, TN: John Wiley & Sons (Lecture Notes)
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Salmon, J. F. (2019) Kanski’s clinical ophthalmology. 9th edn. London, England: Elsevier Health Sciences.