Gonococcal Ophthalmia Neonatorum Despite Treatment with Antibacterial Eye-drops

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Abstract
Over a five-year period, 1964-8, 48 cases of gonococcal ophthalmia neonatorum were notified to the department of venereology in Glasgow. Thirty-seven babies were born in hospital and 11 at home. The conjunctivitis, usually recorded as a “sticky eye,” developed between 1 and 13 days of birth, 36 by the fourth day. Diagnosis by culture of Neisseria gonorrhoeae was delayed in some cases up to 30 days after the appearance of the signs for those born in hospital and 15 days for those born at home, usually because of the blind use of antibacterial eye-drops which produced temporary alleviation of the signs without eradicating the infection; chloramphenicol was noteworthy in this respect. A “sticky eye” will resolve without the use of antibacterial agents, ophthalmia neonatorum will not. When it is decided to use an antibacterial agent pretreatment conjunctival smears for immediate staining and swabs for culture should be taken and the case notified to the medical officer of health. Gonococcal ophthalmia is a preventable disease. In view of the obstetricians' already heavily committed clinical work load there is need for venereologists to collaborate, on consultation and within the maternity hospitals wherever possible, in the screening of antenatal patients for candidiasis and trichomoniasis as well as for gonorrhoea. Some target groups, those with a pathological vaginal discharge or with certain adverse social factors, warrant more thorough investigation, while all those treated require further examination to ensure cure.