Conjunctivitis in Newborns

(Neonatal Conjunctivitis; Ophthalmia Neonatorum)

ByBrenda L. Tesini, MD, University of Rochester School of Medicine and Dentistry
Reviewed/Revised Oct 2022
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Conjunctivitis is inflammation of the conjunctiva, the membrane that lines the eyelid and covers the white of the eye.

  • Conjunctivitis is caused by bacteria, viruses, or a reaction to chemicals.

  • Symptoms vary but may include inflammation of and a discharge from the eyes.

  • The diagnosis is typically based on the appearance of the eyes.

  • The infection may be prevented by drops or ointments that are put in the eyes after birth.

  • Antibiotics and antibiotic ointments are given to treat the infection.

An Inside Look at the Eye

(See also Overview of Infections in Newborns and Infectious Conjunctivitis.)

Causes of Conjunctivitis in Newborns

Conjunctivitis in newborns can be caused by an infection or by a reaction to chemicals put into the eyes (called chemical conjunctivitis). An infection can be caused by bacteria or viruses.

If certain bacteria are present in the mother's vagina, they can be passed to the newborn during delivery. Such bacteria include Chlamydia, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria gonorrhoeae, and others.

Chemical conjunctivitis is a reaction to the eye drops that newborns receive to prevent infection.

Symptoms of Conjunctivitis in Newborns

Symptoms of conjunctivitis may vary depending on the cause of the infection.

Conjunctivitis caused by chlamydia usually begins 5 to 14 days after delivery but sometimes as late as 6 weeks after. Newborns have swollen eyelids and a watery discharge from the eyes that contains increasing amounts of pus. The infection can sometimes be severe.

Conjunctivitis caused by gonorrhea usually begins 2 to 5 days after delivery. Newborns have severe inflammation of the eyelids and discharge of pus from the eyes. Without treatment, blindness may occur.

Conjunctivitis caused by chemicals, such as eye drops, usually begins within 6 to 8 hours after the drops are put in and goes away by itself within 2 to 4 days.

Conjunctivitis in a Newborn
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This image shows conjunctivitis in a newborn characterized by severe inflammation of the eyelids and by discharge of pus.
DR M.A. ANSARY/SCIENCE PHOTO LIBRARY

Conjunctivitis caused by other bacteria begins from 4 days up to several weeks after delivery.

Diagnosis of Conjunctivitis in Newborns

  • Testing of the eye discharge

Doctors evaluate the newborn's symptoms and appearance of the eyes.

Samples of eye discharge are sent to a laboratory to identify the infecting organism.

Prevention of Conjunctivitis in Newborns

Neisseria gonorrhoeaeChlamydia.

Treatment of Conjunctivitis in Newborns

  • Antibiotics

For conjunctivitis caused by Chlamydia,

For conjunctivitis caused by Neisseria gonorrhoeae,

For conjunctivitis caused by other bacteria,erythromycin

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