Ophthalmia Neonatorum and childhood blindness!

Optom
In our quest to fight against childhood blindness, I decided to start discussing some common causes of childhood blindness. Ophthalmia Neonatorum refers to any bilateral infection of the eyes of a child of less than one month old! Inshort, if your kid/ward of less than one week tears profusely, suspect ophthalmia neonatorum! Also suspect it when the child's eyeslids are swollen, shut and often smeared with mucous discharge especially produced by Neisseria Gonorrhoae as the infecting agent.
Other organisms too can cause Ophthalmia neonatorum. They include other bacterias like Staphylococcus aureus, streptococcus Pneumonia, Streptococcus haemolyticus; Serotypes D & K of Chlamydia Trachomatis; Chemicals used as prophylasis, Herpes Simplex virus etc But the Gonorraoeae type is the most complicating!
The eventual complication of Ophthalmia neonatorum is a form of corneal blindness that starts with corneal ulcer which then progresses to anterior staphyloma secondary to the opacification that the corneal ulcer precipitated.

This condition is often arrested by using a prophylasis like Silver Nitrate 1% in Crede's Method or the use of antibiotics like Erythromycin 0.5% or Tetracycline 1% drops one or two hours after birth of especially @ risk children. It should be noted that a pregnant woman an STD infection stands a very high chance of giving birth to a child with Ophthalmia neonatorum. Again, if there was injury to the child in the his or her eyes during delivery. The child could be infected in the womb or during delivery or after delivery! The most common infection comes during delivery. While Gonorrrhoeae type of the infection is reducing drastically globally, its a very common cause of Ophthalmia neonatorum in African children; while the Chlamydia type is the most common cause of this disease in children in developed economies! The onset of infection varies from infecting organisms from a matter of hours to days! But the end result, if not treated on time, is corneal blindness in these children. So beware.
While the best way to manage this disease is by either prevention, where the @risk mother is treated of any STDs and/or the child is treated prophylactically; some situations where the infection has become clinical requires a vigorous use of anti-biotics to manage after a microbial swab test has isolated the infecting organism (it should be noted that cemical induced Ophthalmia neonatorum is a self limiting condition, but do not relent to seek medical advice. It could save the eye of that child!).
An intensive use of broad spectrum antibiotic ophthalmic solution and ointment is very important. Check for any keratitis and manage it immediatly (The corneal involvement is usually very dangerous, blindness could occur in a matter of days!). Ocassionally systemic injections or tablets of broad spectrum antibiotics has proven to help in management of this condition!
In Vision 2020-right to sight, Ophthalmia neonatorum is a major issue in childhood blindness which has recieved an international attention. We ask Optometrists to be in the fore-front of tackling this menancing condition especially in Africa. We ask for a program that'll involve us educating mid-wives and gynacologists on the need for prophylasis in the new born child. We should also remind traditional mid-wives on the need for this eye-saving prophylasis! Vitamin A deficiency, Ophthalmia neonatorum and Measles in children are the main cause of corneal blindness and especially in developing countries like ours. This type of blindness in irreversible, but could be tackled after going through this article! We can give this children a sense of belonging by saving them from a live time of blindness and poverty! I will discuss Vitamin A deficiency as a cause of corneal blindness in my next article!
Great Optometry!
Great!
To be continued...
Dr Ezebuiroh Victor Okwudiri.