dr. Shirley L A,Sp.A

Conjunctivitis is common in childhood and may be infectious or noninfectious

A form of conjunctivitis occuring in infants younger than 4 wk of age

Most common eye disease of newbornsIts many different etiologic agents vary

greatly in their virulence and outcomeConjungtivitis during the neonatal period is

usually acquired during vaginal delivery and reflect the sexually transmitted diseases prevalent in the community

Neisseria gonorrhoeae and Pseudomonas are capable of causing corneal perforation, blindness and death

Risk depends on : - frequencies of maternal infections - prophylactic measures - circumstances during labor and delivery - postdelivery exposures to microorganisms

Clinical manifestations :

not specific enough to allow an accurate diagnosis

redness & chemosis

(swelling) of the conjunctiva, edema

of the eyelids & discharge, may be purulent

Diagnosis : Conjungtivitis appearing after 48 hr should be

evaluated for a possibly infectious cause gram stain of purulent discharge and material culture

Treatment : Gonococcal ophthalmia : - Ceftriaxone 50 mg/kg/24 hr for 1 dose not to exceed 125 mg - Irrigated with saline every 10-30 min, gradually

increasing to 2 hr intervals until purulent discharge has

cleared

Prognosis and prevention : - 0.5% of erythromycin drops into the open eyes at birth - An infant born to a woman who has untreated gonococcal infection single dose of ceftriaxone 50 mg/kg (max 125 mg) IV or IM, in addition to topical prophylaxis - Penicillin (50,000 units) should be used if the

mother’s gonococcal isolate is known to be penicillin

sensitive

Characterized by more or less generalized conjunctival hyperemia, edema, mucopurulent exudate and various degree of ocular dicomfort

Most frequent causes : Haemophilus influenzae (associated with ipsilateral otitis media), pneumococci, staphylococci, and streptococci

Conjunctival smear and culture Usually respond well to warm compresses and

frequent topical instillation of antibiotic drops

Generally characterized by a watery discharge

Follicular changes (small aggregates of lymphocytes) in palpebral conjungtiva

Common : adenovirusCommonly associated

with such systemic viral infections

Self-limited