Yes, newborns can develop pink eye, medically known as neonatal conjunctivitis or ophthalmia neonatorum. This condition is the inflammation of the conjunctiva, the thin membrane covering the white part of the eye and the inner surface of the eyelids. While pink eye is common in infants, it should never be managed at home, unlike in older children. Any signs of eye redness, swelling, or discharge in a baby under one month old require immediate evaluation by a healthcare professional. Prompt medical attention is necessary because the causes range from mild irritation to serious infections that pose a risk to the baby’s vision.
Unique Causes of Newborn Conjunctivitis
The reasons a newborn develops conjunctivitis are often distinct from those affecting older children or adults, primarily relating to events around the time of birth. The most concerning causes are infectious agents acquired as the baby passes through the birth canal, grouped under the term ophthalmia neonatorum.
Infectious Causes
The bacterium Chlamydia trachomatis is the most prevalent infectious cause, typically presenting symptoms between five and fourteen days after delivery. A far more dangerous, though less common, bacterial cause is Neisseria gonorrhoeae, which has a rapid onset, usually within two to five days after birth.
Chemical Irritation
Chemical conjunctivitis results from the prophylactic eye drops administered to newborns shortly after delivery. These antibiotic ointments are given to prevent severe bacterial infections but can cause mild, transient irritation. This type of pink eye is typically mild, appears within the first 24 hours of life, and is generally self-limiting.
Blocked Tear Duct (Dacryostenosis)
A third frequent cause is dacryostenosis, or a blocked tear duct. This structural issue occurs when the nasolacrimal duct fails to open completely, affecting approximately 6% of newborns. The stagnant collection of tears and mucus can mimic conjunctivitis, causing persistent watery eyes and discharge. This blockage can also lead to a secondary bacterial infection because the natural flushing action of tears is impaired.
Identifying Signs and Symptoms
Parents must observe both the appearance of the eye and the nature of any discharge, as these details help determine the underlying cause. The most universal sign of newborn conjunctivitis is redness of the conjunctiva, which may be accompanied by swelling of the eyelids. Infectious causes, such as chlamydia or gonorrhea, often appear bilaterally, though one eye may show more severe symptoms.
The type of discharge is a key differentiator. Chemical irritation causes a watery or minimal discharge. A chlamydial infection typically produces a mucoid or mucopurulent discharge. A gonococcal infection is characterized by a rapid onset of profuse, thick, pus-like discharge.
An infant whose symptoms are primarily excessive tearing and persistent watery or sticky discharge, without significant redness, may have a blocked tear duct. The discharge from a blocked duct often reappears quickly. If a blocked tear duct becomes secondarily infected, the discharge will become thicker and yellowish-green, and the eyelids may become red and tender.
Treatment Approaches and Medical Intervention
Seeking immediate medical evaluation is the first step to determine the specific cause. The severity of the infection dictates the urgency of care, and a doctor will often swab the eye discharge for laboratory testing to identify the causative organism. Treatment is always tailored to the diagnosis.
For confirmed bacterial infections, the approach varies based on the pathogen. A chlamydial infection requires systemic oral antibiotics, such as erythromycin or azithromycin, because the bacteria often infect other areas like the nasopharynx. Gonococcal conjunctivitis is treated with intravenous or intramuscular antibiotics, like ceftriaxone, and the infant is usually hospitalized due to its potential for rapid progression and serious complications.
If the cause is chemical irritation from prophylactic drops, treatment is typically supportive, resolving on its own within 24 to 36 hours. For blocked tear ducts, the primary intervention is nasolacrimal massage, where a caregiver gently “milks” the duct to encourage the opening. Topical antibiotic drops are reserved for cases where a secondary bacterial infection develops in the stagnant tears.
Prevention and Long-Term Outlook
Simple hygiene practices are the most effective daily measures caregivers can take to prevent the spread of infection. Caregivers should maintain strict hand hygiene, especially before and after touching the baby’s face. Gently cleaning the baby’s eyelids with sterile water or saline solution helps remove any discharge build-up.
The routine administration of antibiotic eye ointment at birth is a widely practiced preventative measure aimed at guarding against severe gonococcal infection. This prophylaxis has dramatically reduced the incidence of this blinding form of the disease.
The prognosis for an infant diagnosed with conjunctivitis is generally very favorable, provided the condition is promptly and accurately treated. Most cases resolve completely without lasting effects on the baby’s vision. However, if severe infections, particularly gonococcal, are left untreated, they can rapidly lead to corneal ulceration, scarring, and permanent visual impairment.