Ophthalmia neonatorum (ON), is a broad term that includes all forms of acute and mucopurulent eye infection in the first four weeks of life and is usually acquired by the newborn during passage through the infected birth canal. The spectrum of infectious pathogens that cause neonatal conjunctivitis differs in several parts of the world, due to differences in prenatal maternal care and use of prophylactic treatment to prevent infections in the pregnant mother and the newborn. The most common infectious causes of ON include Chlamydia trachomatis, Staphylococcus aureus, Staphylococcus epidermidis, Neisseria gonorrheae, other gram-negative bacteria and the herpes simplex virus; Chlamydia and Neisseria being the most common pathogens. Fortunately, in most cases, laboratory studies can identify the causative organism and, unlike other forms of conjunctivitis, this perinatal eye infection must be treated with systemic antibiotics to prevent systemic colonization of the organism. ON remains an important cause of eye morbidity, blindness and even death in underdeveloped countries. Routine prophylaxis with 1% silver nitrate solution has been discontinued in many developed countries for fear of the development of chemical conjunctivitis. Currently the recommended prophylaxis is 1cm of topical erythromycin at 0.5% ointment or 1% tetracycline in all newborns during the first hour of life.
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