UMEM Educational Pearls

Category: Pediatrics

Title: Neonatal Conjunctivitis

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

Posted: 2/2/2008 by Sean Fox, MD (Emailed: 2/8/2008) (Updated: 7/18/2019)
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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.