Conjunctivitis of Neonates, Infants and Toddlers

Overview

The submitted paper summarizes from the aspect of the child ophthalmologist and neonatologist in collabora-tion with a microbiologist and virologist the clinical problem of conjunctivitis in neonates, infants and toddlers asregards incidence, forms, the etiological agent and its detection and therapeutic principles. Although life threate-ning conditions are not involved, conjunctivitis is one of the most frequent ophthalmological diseases. Thetherapeutic procedure follows several principles. In neonates it is important in the first place to rule out the possibletransmission of a Chlamydial infection, infrequently HSV infection and rarely gonococcal infection from motherto the neonate. In the majority of contaminations from the environment in the infection staphylococci, streptococci,E. coli and other Gram negative bacteria participate. In the differential diagnosis it is important to rule outobstruction of the lacrimal pathways in infants as the most frequent cause of conjunctival irritation in this agegroup. In addition to a fundamental evaluation of the clinical picture the diagnosis should be based also on isolationof the infectious agent. This creates prerequisites for properly selected local and systemic treatment. The optimalform of antibacterial substances for this age group are eye drops. Infections not responding or poorly respondingto treatment or relapses of conjunctivitis should always be referred to an experienced ophthalmologist. This appliesin particular to indications for local corticosteroid application.

Key words:
conjunctivitis, neonatal ophthalmia, HSV, Chlamydia trachomatis, obstruction of the lacrimalpathways, antibiotics