eMedicine Specialties > Ophthalmology > Conjunctiva

Conjunctivitis, Neonatal: Follow-up

Author: Kalpana K Jatla, MD, Private Practice, Clarity Eye Center
Coauthor(s): Robert William Enzenauer, MD, MPH, Professor, Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center; Feng Zhao, MD, PhD, Staff Physician, Department of Ophthalmology, Emory Cartersville Medical Center
Contributor Information and Disclosures

Updated: Nov 17, 2008

Follow-up

Further Outpatient Care

  • Follow up in 1 day to ensure that the patient responds to treatment.

Inpatient & Outpatient Medications

  • Discharged patients should continue the treatment, according to clinical presentations and available culture results. Treatment may be modified later per culture results.
  • Avoid eye patching.

Deterrence/Prevention

  • Wearing gloves and frequent hand washing is necessary to reduce transmission.

Complications

  • If untreated, corneal ulceration may occur in N gonorrhoeae infection and rapidly progress to corneal perforation.
  • When unrecognized and not immediately treated, Pseudomonas infection may lead to endophthalmitis and subsequent death.
  • Pneumonia has been reported in 10-20% of infants with chlamydial conjunctivitis.

Prognosis

  • Neonatal conjunctivitis usually responds to appropriate treatment, and the prognosis generally is good.

Patient Education

  • Educate parents or care providers to wash their hands frequently to prevent transmission.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Pinkeye.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize or treat gonococcal conjunctivitis
  • Failure to provide preventive measures in newborns
  • Failure to exclude other potential causes of acute red eye (eg, preseptal cellulitis, orbital cellulitis)

Special Concerns

  • Consider the risk of transmission of chlamydia, gonococcus, herpes, and streptococcus to the fetus during the birth process. Obtain cervical cultures (if indicated), and manage appropriately.
  • Newborns with conjunctivitis are at risk for secondary infections, such as pneumonia, meningitis, and septicemia, which can lead to sepsis and death.
  • Infants with a potentially sexually transmitted disease, such as gonorrhea or chlamydia, should undergo evaluation for other sexually transmitted diseases, such as syphilis and HIV, as should the mother and her sexual partner(s).
 


More on Conjunctivitis, Neonatal

Overview: Conjunctivitis, Neonatal
Differential Diagnoses & Workup: Conjunctivitis, Neonatal
Treatment & Medication: Conjunctivitis, Neonatal
Follow-up: Conjunctivitis, Neonatal
Multimedia: Conjunctivitis, Neonatal
References
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References

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Further Reading

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Keywords

neonatal conjunctivitis, ophthalmia neonatorum, infectious conjunctivitis, conjunctiva

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Contributor Information and Disclosures

Author

Kalpana K Jatla, MD, Private Practice, Clarity Eye Center
Kalpana K Jatla, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

Robert William Enzenauer, MD, MPH, Professor, Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center
Robert William Enzenauer, MD, MPH is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Hamilton County Medical Society Salary Consulting

Feng Zhao, MD, PhD, Staff Physician, Department of Ophthalmology, Emory Cartersville Medical Center
Feng Zhao, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

Medical Editor

Gerhard W Cibis, MD, Clinical Professor, Director of Pediatric Ophthalmology Service, Department of Ophthalmology, University of Kansas, Kansas City
Gerhard W Cibis, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Ophthalmological Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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