| Cause |
Characteristics |
Treatment |
| Chlamydia trachomatis |
About 80% of infectious red eyes in infants
Onset day 2 to week 8
Mild to Severe
Organisms seen on direct fluorescent antibody stain of conjunctival scrapings
Associated pneumonia common
Rarely causes ocular damage even untreated
|
Tetracycline ointment qid for 4 weeks; oral erythromycin for 4 weeks
Treat parents with oral doxycycline or erythromycin for 4 weeks |
| Neisseria gonorrhoeae |
Less than 5% of infectious red eyes in infants
Onset day 2 to 4
Usually hyperacute, but may be mild initially
Purulent discharge
Gram-negative intracellular cocci on scrapings
Inadequate treatment leads to corneal perforation and blindness |
Topical aqueous penicillin 20,000 units/ml, one drop hourly
Intravenous aqueous penicillin 50,000 units daily or ceftriaxone 50 to 75mg/kg/day for 7 days |
Staphylococcus, Streptococcus,
gram-negative bacteria |
Uncommon
Onset usually after 5 days, but may be earlier
Mucopurulent discharge
May be associated with sepsis
Can lead to corneal perforation
Diagnosis by smear and culture |
Gram-positive organisms and Haemophilus: erythromycin ointment 6 times daily
Other gram-negative organisms: topical gentamicin every 1 to 2 hours |
| Herpes Simplex |
Uncommon
Onset day 5 to 10
Usually type 2
Watery discharge
Lid often swollen
May be associated with mucocutaneous vesicles, systemic (including choroid, central nervous system) involvement
Conjunctival smears show absence of polymorphonuclear leukocytes
Viral cultures definitive |
Topical trifluorothymidine, vidarabine, or idoxuridine qh
Intravenous acyclovir
Oral acyclovir 800mg 5x/day for 10 days |
