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EYE OINTMENT

Why is it done?

 

Typical hospital protocol is to instill a petroleum-based antibiotic ointment into baby’s eyes

immediately postpartum. This is done because gonorrhea or chlamydia can cause blindness or

infection if contracted by the baby. Other bacterial infections may cause the baby eye irritation,

but do not cause blindness.

 

What medications are used?

Silver nitrate drops used to be the medication used to prevent blindness from gonorrhea. Silver

nitrate may cause chemical conjunctivitis (an eye infection) and causes a chemical inflammation

of the eyelids and burns the corneal surface slightly as it penetrates to kill bacteria. This may

result in swelling, redness, and plugged tear ducts. Fortunately silver nitrate has since fallen out

of favor and erythromycin, a petroleum-based antibiotic ointment, is the most common

medication used today as it causes much less irritation, but may still cause burning, redness,

blurred vision (which can interfere with bonding) and plugged tear ducts. Irritation may be more

severe in those with hypersensitivity. Erythromycin is effective against certain strains of

staphylococcus, streptococcus, pneumonia, influenza, syphilis, gonorrhea, and chlamydia,

however does not provide complete protection against chlamydia and only IV antibiotics can

prevent gonorrheal blindness in an active neonatal infection.

 

Are there alternatives?

A cheap, available medicinal alternative is a 2.5% solution of povidone-iodine (¼ teaspoon

Betadine plus ¾ teaspoon water), which is more effective against chlamydia and has the same

effectiveness as erythromycin against gonorrhea. It should be noted that there is some risk of

alteration of thyroid function with excess iodine

A non-medicinal alternative is to rinse the newborn’s eyes with sterile water immediately after

birth and watch closely for signs of infection, treating only if infection is suspected. You may

also place a few drops of breast milk directly from the breast into each eye, being careful not to

touch the breast to the infected eye. You may do this daily for a week. Another alternative is to

clean the eyes with chamomile tea with a tiny pinch of powdered goldenseal added.