Ophthalmia Neonatorum
Reporting Obligations
Individuals who have or may have ophthalmia neonatorum shall be reported to the local Health Unit.
Epidemiology
Aetiologic Agent
Eye infection of newborn infant acquired during birth and caused by a maternal infection with Neisseria gonorrhoeae (N. gonorrhoea), and/or Chlamydia trachomatis (C. trachomatis).
Clinical Presentation
Acute, inflammatory condition of the eye, occurring within 3 weeks of life. Signs and symptoms include purulent conjunctivitis, and swollen red eyelids.
Modes of Transmission
Contact with the infected birth canal during childbirth.
Incubation Period
Usually 1–5 days for gonococcal infection; 5–12 days for chlamydial infection.
Period of Communicability
While discharge persists, if untreated; no longer communicable after 24 hours of treatment.
Risk Factors/Susceptibility
Contact with the infected birth canal during childbirth.
Contact with the infected maternal genital tract.
Diagnosis and Laboratory Testing
The most common infectious cause is C. trachomatis, which produces inclusion conjunctivitis that usually appears 5–14 days after birth.
Confirmed case:
- Laboratory confirmation of Neisseria gonorrhoeae or Chlamydia trachomatis in conjunctival specimens from an infant (most commonly occurs in infants less than or equal to 28 days in age)
Probable case:
- Laboratory confirmation of Neisseria gonorrhoeae or Chlamydia trachomatis in maternal specimen AND/OR
- Clinically compatible signs and symptoms in an infant (most commonly occurs in infants less than or equal to 28 days in age)
Clinical Evidence:
- Acute redness and swelling of conjunctiva in one or both eyes, with mucropurulent or purulent discharge in which gonococci are identifiable by microscopic and culture methods. Corneal ulcer, perforation and blindness may occur if specific treatment is not given promptly.
Treatment and Case Management
Treatment is under the direction of the attending health care provider. Mother and infant should both be treated for the appropriate infection. Contact isolation should be employed for the first 24 hours after treatment begins. Refer to Canadian Guidelines on Sexually Transmitted Infections 2010. For treatment of mother with Gonorrhea, refer to Ontario Gonorrhea Testing and Treatment Guide.
Additional Resources
Ophthalmia Neonatorum | Public Health Ontario
Public Health Agency of Canada. “Canadian Guidelines on Sexually Transmitted Infections, 2010.”
Public Health Ontario. “Ontario Gonorrhea Testing and Treatment Guide, Second Edition.”
References
Heymann, D.L. Control of Communicable Disease Manual (19th Ed.). Washington, American Public Health Association, 2008.
Ministry of Health and Long-Term Care, Infectious Diseases Protocol, 2022.