Ophthalmia neonatorum

The common causes of childhood blindness that affects the retina are hereditary dystrophies, retinopathy of immaturity and toxoplasmosis. Corneal blindness could be due to vitamin A deficiency, measles and Ophthalmia neonatorum. Congenital rubella affects the lens of the eye. Other congenital conditions and cortical blindness can also attribute to blindness in children.

Ref: Pediatric Retina: Medical and Surgical Approaches, Mary Elizabeth Hartnett, M.D., Page: 318

The most common etiologies of ophthalmia neonatorum are chemical conjunctivitis (hyperemia and mucoid discharge during the first 24 hours postpartum) caused by silver nitrate or erythromycin prophylaxis, herpes simplex, Neisseria gonorrhoeae and N. meningitidis, and Chlamydia trachomatis.

The common causative organisms of ophthalmia neonatorum include Chlamydia trachomatis (most common), Neisseria gonorrhoeae (most threatening), Haemophilus species, Streptococcus species, Staphylococcus aureus, and viruses such as Herpes simplex (HSV). 

Ans. is ‘a’ i.e., Corononary heart disease; ‘b’ i.e., LGV; ‘c’ i.e., Ophthalmia Neonatorum

.  “Epidemiological studies have demonstrated an association between serologic evidence of C. pneumoniae infection and atherosclerotic disease of the coronary and other arteries.”  

.  “Occasiaonal patients develop endocarditis and C. psittaci infection should be considered in cases of culture-negative endocarditis.”  

.   Pneumonia caused by C. pneumoniae resembles the primary atypical pneumonia of M. pneumoniae.

.  C. trachomatis types D to K can cause ophthalmia neonatorum.

.  C. trachomatis (type LI; L2, L3) causes L.G.V.

A i.e. Gonorrhoea; C i.e. Chlamydia

A i.e. Gonococcus; B i.e. Chlamydia

D i.e. Silver nitrate

• 1% AgNO₃ (Crede’s prophylaxis) used to prevent gonococcal opthalmia in new born is not used now as it leads to opthalmia neonatorum. It is important to note here that 1% AgNO₃ is used for prophylaxis of gonococcal opthalmia, and it has got no role in treatment of opthalmia neonatorum. In fact it is a cause of opthalmia neonatorum.
• If Ophthalmia Neonatorum is confirmed then the treatment is started on the lines of Gonorrhoeal infection and the treatment modified on the microbiological studies and clinical response.

D i.e. Congenital dacryocystitis

Ans. Inflammation of the conjunctiva occurring in an infant less than 30 days old

Ans. None of the above

Ans. Aspergillus

Ans. Congenital dacryocystitis

Ans. B i.e. Herpes simplex virus II

Ophthalmia neonatorum

• Time frame of signs/ symptoms following birth play an important role in determining the most likely etiology and subsequent proper diagnosis and treatment
• Within 48 hours: Chemical conjunctivitis (Typically presents within first 24 hours following birth) & Niesseria gonorrhoe
• 48-72 hours: Staph. aureus, Strepto. Hemolyticus
• 5-7 days: HSV-II
• More than 1 week: C. trachomatis (D-K)

Ans. is ‘d’ i.e., Moraxella

Ophthalmia neonatorum

• Ophthalmia neonatorum, also called neonatal conjunctivitis, is the conjunctivitis in the first month of life. Infection may be acquired during birth from infected birth canal (most common) or after birth. The causative agents are : –

1. Common organisms are : – Gonococcus, C. trachomatis, Herpes simplex virus. Other organisms are : -Staphylococcus aureus, pneumococcus, Streptococcus, Pseudomonas, Serratia, Klebsiella.
2. Chemical conjunctivitis : – Caused by use of silver nitrate or antibiotic prophylaxis.