Ophthalmia neonatorum: study of a decade of experience at the Mount Sinai Hospital.

We reviewed the charts of neonates who received a diagnosis of conjunctivitis or ophthalmia neonatorum during a 10-year period at the Mount Sinai Hospital, New York City. Ninety-five cases were discovered, four of these were born elsewhere and were not subject to our protocol, which at present consists of intramuscular penicillin and topical tetracycline ointment (1%). The 91 cases represent an incidence of 3.1 cases per 1000 live births (9.1/year), an incidence approximately equal to that reported in other published studies. The clinical characteristics examined were: age, sex, race, birth weight, gestational age, Apgar scores, presence or absence of fever or other systemic illnesses, complications, type of delivery, time of year, incubation period, presence and type of discharge, uni- or bilaterality, Gram stain, Giemsa stain, culture results, antibiotic disc sensitivities, cervical culture, antibiotic therapy, sequelae, and type of prophylaxis received. Seven aetiological diagnostic categories were established: gonococcal (3%), chlamydial (3%), staphylococcal (30%), other pathogens (25%), chemical conjunctivitis (7%), culture negative/normal flora (22%), and unobtainable (10%). This distribution differs from others published. In contrast with other studies, moreover, we found few gonococcal and no chlamydial cases in neonates subject to the Mount Sinai Hospital treatment protocol. Correlation of clinical characteristics and aetiological categories showed no statistically significant trend. So far there have been no cases of ophthalmia neonatorum, treated as on our protocol, caused by penicillin resistant gonococci or chlamydiae.