Ophthalmia neonatorum

Ophthalmia neonatorum is an eye infection that occurs within the first 30 days of life. It is caught during birth from infection of the mother’s birth canal with a sexually-transmitted disease. Chlamydia has replaced gonorrhoea as the most common cause. Symptoms include redness, discharge and eyelid swelling. The condition may result in a severe and progressive conjunctivitis with corneal complications. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing ophthalmia neonatorum. It highlights the potential for severe complications and the need for emergency referral.

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What is ophthalmia neonatorum?

The definition of Ophthalmia Neonatorum (conjunctivitis of the newborn) is an eye infection that develops within the first 30 days of life.  It is passed to the child during birth by contact with the mother’s birth canal that is infected with a sexually-transmitted disease.  The infection may be bacterial, chlamydial or viral.  Historically, gonorrhoea was the usual cause, but chlamydial infection is now more common. Globally, the prevalence of this infection varies widely according to prevailing socio-economic conditions, health education and maternal healthcare.

The baby’s eyes are red, the eyelids and the whites of the eyes are swollen and there is watering or a discharge. Usually both eyes are affected, but one may be worse than the other. One of the dangers of gonococcal infection (infection with the organism that causes gonorrhoea) is that it may also affect the cornea (the clear layer at the front of the eye). 

How is ophthalmia neonatorum managed?

Early diagnosis and treatment is very important and for this reason, the optometrist should refer all cases immediately to an ophthalmologist (specialist eye doctor). After swabs have been taken for culture, treatment with antibiotics will be started without delay. The antibiotics will be given by mouth, by injection or into a vein (intravenously), and in eye drop form.

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Last updated

Opthalmia neonatorum - 9 October 2026
The aetiology section has been amended to reflect current antenatal practices in the UK for reducing the risk of ophthalmia neonatorum. The symptoms and signs sections have been revised to highlight the typical presentation in gonococcal infection. The differential diagnosis section now includes other sight threatening conditions that may present similarly to ophthalmia neonatorum. The non-pharmacological management section emphasises the importance of appropriate infection prevention and control measures during and after physical examination in cases of confirmed or suspected ophthalmia neonatorum. 

Version 14                                                                                                                      
Date of search 14.07.26
Date of revision 06.07.26
Date of publication 09.10.26
Date for review 13.07.28

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