Ophthalmia neonatorum causes

Tetracycline and erythromycin Tetracycline and erythromycin also are indicated for the prophylaxis of ophthalmia neonatorum caused by Neisseria gonorrhoeae or Chlamydia trachomatis. 

For prophylaxis of ophthalmia neonatorum, various groups have proposed the use of erythromycin (0.5%) or tetracycline (1%) ophthalmic ointment in lieu of silver nitrate. Although silver nitrate and antibiotic ointments are effective against gonococcal ophthalmia neonatorum, silver nitrate is not effective for chlamydial disease and may cause a chemical conjunctivitis. 

Clinical manifestations of bacterial ophthalmia neonatorum are nonspecific and similar to those caused by other pathogens discussed previously. Infants experience the acute onset of hyperemia, chemosis, eyelid edema, and purulent or mucopurulent exudate 5 to 21 days postpartum. Practitioners should take care to rule out nasolacrimal duct obstruction, a finduig that is relatively common in newborns and that can be associated with a secondary bacterial infection. 

Herpes Simplex Virus Ophthalmia Neonatorum. HSY infection is an uncommon but important cause of neonatal infection and is associated with conjunctivitis in 5% to 10% of cases.The clinical manifestations are nonspecific and include conjimctival hyperemia, chemosis, periorbital edema, and mucous discharge. Corneal involvement is not uncommon and can include dendritic, geographic, or stromal keratitis. Herpetic ophthalmia neonatorum represents a primary herpetic infection. Central nervous system involvement, encephalitis, retinitis, optic neuritis, uveitis, choroiditis, and a fetal viremia can be serious sequelae of primary herpetic infections. 

The use of 1% silver nitrate eye-drops in prophylaxis of ophthalmia neonatorum has been periodically reviewed and compared with other prophylactic measures. There seems to be no case in which permanent damage to the eye was actually proven to have been caused by a single application of a correctly used 1 % silver nitrate solution (23). However, silver nitrate has largely been replaced by antimicrobial drugs. 

Erythromycin ophthalmic ointment is the medication of choice to prevent ophthalmia neonatorum (blindness caused by a gonorrhea infeetion acquired when passing through the birth canal or coming into contact with the mother s tissues). Because the client has had no prenatal care, this would be recommended procedure in case the infant has been exposed to gonorrhea. 

Though silver nitrate causes chemical conjunctivitis in about 90% of the infants in the first 24 hours of life, obvious conjunctivitis is rare after this period. The chemical conjunctivitis does not increase the risk of secondary infection, nor does it mask bacterial infection. Rinsing will not prevent the development of conjunctivitis. Discontinuation of the prophylactic use of silver nitrate appears to result in a significant rise of gonococcal ophthalmia neonatorum in high-risk populations. 

---