Ophthalmia neonatorum

Question 1

what is Ophthalmia neonatorum?

Answer 1

Ophthalmia neonatorum simply means infection of the newborn eye.

Question 1

Responsible organisms?

Answer 1

Responsible organisms include
Chlamydia trachomatis
Neisseria gonorrhoeae

Question 2

management

Answer 2

Suspected ophthalmia neonatorum should be referred for same-day ophthalmology/paediatric assessment.

Question 3

A 3-week-old infant is brought to the GP by his mother who is concerned about a 5-day history of ‘sticky eyes’. On examination, the infant looks systemically well and all observations are within normal range. He has bilateral purulent discharge of the eyes and moderate conjunctival injection.

What is the appropriate management of this patient?

Give advice about eyelid hygiene and gentle massage
Prescribe topical chloramphenicol ointment
Refer to ophthalmology to be seen the same day
Routine referral to ophthalmology
Take a swab and await results prior to treatment

Answer 3

Suspected ophthalmia neonatorum should be referred for same-day ophthalmology/paediatric assessment
Important for meLess important
Purulent discharge and conjunctival inflammation are suggestive of ophthalmia neonatorum, rather than nasolacrimal duct obstruction. Give advice about eyelid hygiene and gentle massage is therefore not the correct answer.

Prescribe topical chloramphenicol ointment is the correct management of bacterial conjunctivitis in older children, but as this infant is less than 30 days old they need urgent refer to ophthalmology for management of ophthalmia neonatorum.

Refer to ophthalmology to be seen the same day is the correct answer. Ophthalmia neonatorum is defined as conjunctivitis under 30 days old. Prompt treatment is necessary to prevent serious illness and may require systemic antibiotics.

Routine referral to ophthalmology is not correct as infants should be seen the same day.

Take a swab and await results prior to treatment is also not correct as treatment must be started promptly to prevent the progression of the infection. Swabs are taken to establish the causative agent but treatment should be started before the results.

Question 4

summarise

Answer 4

Ophthalmia neonatorum

Ophthalmia neonatorum simply means infection of the newborn eye.

Responsible organisms include
Chlamydia trachomatis
Neisseria gonorrhoeae

Suspected ophthalmia neonatorum should be referred for same-day ophthalmology/paediatric assessment.