INFLAMMATION OF THE EYE OF NEWLY BORN (OPHTHALMIA NEONATORUM)
Categories:
Diseases of The Eye and Ear
This is a
severe inflammation of the conjunctiva in the new born infant, usually due
to a discharge from the mother and it is characterized by a discharge of
pus.
Causes. Mild cases may come from a less violent form of infection from
the mother's discharge from the vagina, or from outside causes. The
majority of the severe cases is due to a poison (the gonococcus
infection).
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Symptoms. The first symptoms are swelling and redness, usually of both
eyes, usually occurring a few days after birth. Soon the discharge appears
and shortly becomes creamy pus, which runs from the eyes when the swollen
lids are partly opened. As the disease continues to advance, the membrane
of the lid is thickened, red and velvety looking and the conjunctiva
(membrane) in the eye is swollen, puffy and watery.
The disease may last from two to six weeks or longer.
If the pus is not cleaned from the eye, the cornea may look dim and ulcers
may appear. If the ulcer eats through the cornea the iris is apt to be
caught in the opening and in the scar resulting from the ulcer. The cornea
may later bulge and protrude or the disease may involve the whole eye in
an inflammation which may destroy it.
The result generally depends upon how soon treatment is begun. If attended
to early the great majority of cases recover. It is serious to neglect
early treatment for this disease. It causes a great many cases of
blindness and generally the cases are neglected too long. Treatment must
begin before the disease begins. Immediately at the birth of the child,
when if there is any poison in the eye due to a discharge in the mother's
vagina, it can be immediately cleansed.
TREATMENT PREVENTIVE. What to do first. As soon as the child is born and
before its eyes are opened the discharges should be carefully wiped away
from the lids with small squares of cotton or gauze, pieces wrung out of a
weak solution, three per cent (three parts to one hundred of warm, boiled,
water) of boric acid. The eyes should not be exposed to the light. At the
first both the eyes should be bathed and the same piece of linen should
not be used for both eyes.
As soon as any redness appears the eye should be frequently bathed with
this warm, weak solution of boric acid and sometimes cold compresses
should be used by taking squares of folded gauze or masses of absorbent
cotton. Take them cold from a block of ice and lay them over the eyes, and
keep constantly changing to keep them cold. This relieves the congestion
and prevents a great amount of blood from flowing and settling
(congestion) there. When pus appears in the eye it should be cleansed
every half hour at least. You can do this by letting the solution run over
it from a medicine dropper. After being allowed to trickle from the outer
to the inner angle (corner) of the eye, it will then run down beside the
nose and can be caught in a piece of absorbent cotton or sponge. If there
is a great amount of pus in the eye, the eye may have to be washed out in
this manner, every fifteen minutes, day and night, so that the cornea will
be kept clean. If this must be done a small fountain syringe with a glass
tube (eye-dropper) attached will cause a steady flow of the solution. The
boric acid can be increased to five or ten grains to the ounce of water.
If only one eye is diseased the other eye may be covered.
All cloths, etc., should be burned at once and the basin which has held
them, filled with carbolic acid solution of the strength of one part acid
to twenty parts water. The nurse's hands should be thoroughly scrubbed in
hot water and soap and disinfected in the same strength of carbolic acid
solution, as the disease is very contagious and dangerous to adults. An
attendant should not touch her face or hair with her hands unless they
have been washed quite clean. The conjunctiva should be brushed with a
solution of nitrate of silver of two per cent strength (two parts to one
hundred of distilled water) and then neutralized with a salt solution, not
strong enough to burn.
When the cornea is diseased one per cent solution of atropine may be
necessary once or twice a day.
Caution. In the cities this disease is disastrous in its results to the
sight of babies. This is due to the want of necessary care. Persons who
must be with the patient should be very careful not to get any of the
discharge upon their clothes or person, as it is very contagious.