Skip to Main Content


Neonatal conjunctivitis (ophthalmia neonatorum or neonatal blennorrhea) is a conjunctivitis that occurs in the first 4 weeks of life. It is the most common ocular disease of newborns, occurring in 1.6–12% of neonates. Neonatal conjunctivitis has been associated with a wide variety of organisms, which have varied in their relative importance over time and geographic location (Table 20–1). The introduction of neonatal ocular prophylaxis and the introduction of routine screening and treatment of pregnant women for gonorrhea and, more recently, Chlamydia trachomatis infection have altered the epidemiology of ophthalmia neonatorum in the United States.3,4 In the nineteenth century, gonococcal ophthalmia was an important cause of blindness in infants; today, it is relatively uncommon in industrialized nations, although it remains a serious problem in many developing countries.1,58 Before the introduction of systematic screening and treatment of C. trachomatis infection in pregnant women in the 1990s, C. trachomatis was the most frequent identifiable infectious cause of neonatal conjunctivitis in the United States.3 Screening and treatment of pregnant women have resulted in a dramatic decrease in perinatal chlamydial infections. However, in countries where pregnant women are not routinely screened, including the Netherlands and many developing countries, C. trachomatis still remains the most frequent cause of neonatal conjunctivitis.2,5

Table Graphic Jump Location
Table 20–1. Infectious Causes of Neonatal Conjunctivitis

Neisseria Gonorrhoeae


The main population at risk of gonococcal conjunctivitis is neonates born to mothers with vaginal infection. The transmission rate in neonates born to infected mothers who have not received ocular prophylaxis may be as high as 42%.1 Neonatal gonococcal ophthalmia (Figure 20–1) may cause primary disease at other mucous membrane sites or systemic disease. Gonococcal conjunctivitis in the newborn usually produces an acute purulent conjunctivitis that appears from 2 to 7 days after birth, although presentations during the second week of life are commonly described. Presentation may be earlier if there has been premature rupture of membranes, but the initial course may, occasionally, be indolent, with onset occurring later than 5 days after birth. Permanent corneal damage following gonococcal ophthalmia neonatorum was usual in the preantibiotic era.3

Figure 20–1.
Graphic Jump Location

Gonococcal ophthalmia. Profuse mulo-purulent discharge in a 5-day-old newborn. Note eryhtema and swelling of the LID. (Shah BR, Lucchesi M. Atlas of Pediatric Emergency Medicine, McGraw-Hill.)


C. Trachomatis


C. trachomatis infection is acquired by ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.