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2015 ; 20
(2
): 93-6
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Preventing ophthalmia neonatorum
#MMPMID25838784
Moore DL
; MacDonald NE
Paediatr Child Health
2015[Mar]; 20
(2
): 93-6
PMID25838784
show ga
The use of silver nitrate as prophylaxis for neonatal ophthalmia was instituted
in the late 1800s to prevent the devastating effects of neonatal ocular infection
with Neisseria gonorrhoeae. At that time - during the preantibiotic era - many
countries made such prophylaxis mandatory by law. Today, neonatal gonococcal
ophthalmia is rare in Canada, but ocular prophylaxis for this condition remains
mandatory in some provinces/ territories. Silver nitrate drops are no longer
available and erythromycin, the only ophthalmic antibiotic eye ointment currently
available for use in newborns, is of questionable efficacy. Ocular prophylaxis is
not effective in preventing chlamydial conjunctivitis. Applying medication to the
eyes of newborns may result in mild eye irritation and has been perceived by some
parents as interfering with mother-infant bonding. Physicians caring for newborns
should advocate for rescinding mandatory ocular prophylaxis laws. More effective
means of preventing ophthalmia neonatorum include screening all pregnant women
for gonorrhea and chlamydia infection, and treatment and follow-up of those found
to be infected. Mothers who were not screened should be tested at delivery.
Infants of mothers with untreated gonococcal infection at delivery should receive
ceftriaxone. Infants exposed to chlamydia at delivery should be followed closely
for signs of infection.
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