UMEM Educational Pearls

Title: Neonatal Conjunctivitis

Category: Pediatrics

Keywords: Neonatal Conjunctivitis, Chlamydia, Gonorrhea, Red Eye (PubMed Search)

Posted: 2/2/2008 by Sean Fox, MD (Updated: 11/22/2024)
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Neonate with Red Eye

Crusty Eye – Not Red
- Dacryostenosis - nasolacrimal duct obstruction
- It is the most common cause of tearing in childhood.
- No photophobia, corneal is normal
- Tx = Warm compresses and gentle massage

Purulent Conjunctivitis - Ophthalmia neonatorum
- Chemical (due to prophylactic eye drops) - day 1
- Gonorrhea –
  - Presents early on (day 2-5)
  - OCULAR EMERGENCY – may cause globe perforation
  - Associated Systemic Infection - meningitis
  - Ceftriaxone (25-50mg/kg) – Treat until Cx’s return.
- Chlamydia –
  - Longer incubation period (day 5-14)
  - Causes Eyelid Scarring leading to blindness
  - Associated Systemic Infection – Pulmonary
  - Ceftriaxone (25-50mg/kg) + Topical Erythromycin
  - If Culture +, then PO erythromycin to prevent late onset pneumonitis.