Neonatal Conjunctivitis

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Overview, Causes, & Risk Factors

Conjunctivitis in a newborn can be caused simply by a blocked tear duct or by irritation produced by the antibiotic eyedrops given at birth. However, if it is caused by an infection, it can be very serious.

Many organisms can cause infection in the eyes of newborn infants. The most common bacterial infections with potential to cause serious eye damage are gonorrhea (Neisseria gonorrhea) and Chlamydia (Chlamydia trachomatis), which can be passed from mother to child during birth.

The viruses that cause genital and oral herpes can also cause neonatal conjunctivitis and severe eye damage. These viruses may also be acquired during passage through the birth canal, however herpes conjunctivitis is less common than those caused by gonorrhea and Chlamydia.

All of these organisms are generally picked up by the expectant mother as a sexually-transmitted disease (STD). Chlamydia may be the most common STD in the United States today and Chlamydial conjunctivitis in the newborn is seen 10 times as frequently as gonorrheal conjunctivitis.

The mother may be without symptoms (asymptomatic) at the time of delivery, yet still harbor bacteria or viruses capable of causing conjunctivitis in the newborn. Infected newborn infants develop drainage from the eyes within 1 day to 2 weeks after birth. The eyelids become puffy, red, and tender.

Gonorrhea may cause perforation of the cornea and very significant destruction of the deeper eye structures. Chlamydia is somewhat less destructive.

Because of the significance of neonatal conjunctivitis, all hospitals (most required by State law) routinely use silver nitrate or antibiotic drops, such as erythromycin, in the newborn's eyes to prevent disease. Silver nitrate is no longer commonly used and has been mostly replaced by antibiotic eye drops.