Ophthalmia neonatorum: should old ways play a role in new realities?

Introduction and Objectives: Neonatal conjunctivitis (NC) prophylaxis was introduced in 1980, reducing its incidence from 10 to 0.3%. However, the epidemiology has evolved in developed countries, with Neisseria gonorrhoeae becoming rare and Chlamydia trachomatis emerging as a prominent cause. Its necessity in developed countries is currently under debate. In our center, before 2006, prophylaxis was carried out on all newborns. Given the lack of cases of blindness due to gonococcal NC, our hospital has not carried out neonatal eye prophylaxis since 2007. The aim is to evaluate our center’s experience over the last 15 years. Methods: A retrospective observational study was carried out. All ocular exudate samples were collected between 2008 and 2022. Among the identified cases of gonococcal conjunctivitis, clinical information was collected. Results: During this period, a total of 30,417 babies were born in our maternity hospital, and 112 ocular exudates were included. We identified only two cases of gonococcal conjunctivitis, both of which were quickly diagnosed and effectively treated, and there were no cases of gonococcal blindness. The incidence of gonococcal conjunctivitis in this population was 0.06 cases per 1,000 live births. No cases of blindness due to gonococcal infection were identified. Discussion: The need for prophylaxis for CN should be discussed. Currently, the indication for it in developed countries is debatable. We believe it is essential to draw up universal guidelines that standardize the existence of possible screening, prophylaxis and its protocol, its application criteria, and the treatment of neonatal conjunctivitis.