Retinal Hemorrhage In Newborns

Retinal Hemorrhage Neonate

Figure 2.6. Retinal hemorrhages occur frequently in the neonate, especially following vaginal delivery. In some studies, the incidence of small retinal hemorrhages is as high as 25% irrespective of whether the delivery was spontaneous or required the application of forceps. These retinal hemorrhages resolve spontaneously without any consequences. In contrast, hemorrhages into the vitreous gel may prevent light from getting through to the retina for several days or even weeks and will cause a severe, irreversible deprivation amblyopia.

Figure 2.4. These figures are of the optic nerves of the infant shown in Figure 2.3, one year later. On the left is the normal right optic nerve; on the right is the left optic nerve which has developed complete optic nerve atrophy, related to stretching of the left optic nerve occurring when the forceps had slipped between the left eye and the nasal orbital wall. As a result, the eye is totally blind.

Figure 2.5. Subconjunctival hemorrhages are very common in the neonate immediately following birth. They resolve spontaneously without any consequences.

Figure 2.6. Retinal hemorrhages occur frequently in the neonate, especially following vaginal delivery. In some studies, the incidence of small retinal hemorrhages is as high as 25% irrespective of whether the delivery was spontaneous or required the application of forceps. These retinal hemorrhages resolve spontaneously without any consequences. In contrast, hemorrhages into the vitreous gel may prevent light from getting through to the retina for several days or even weeks and will cause a severe, irreversible deprivation amblyopia.

Figure 2.7. Chemical conjunctivitis in a premature infant resulting from the use of silver nitrate for Crede prophylaxis. Sometimes this is so severe that it prevents visualization of the eye on the initial examination in the nursery. This usually improves within 24 to 48 hours and an ocular examination should be performed at that time. For prophylaxis, at the present time, different antibiotic preparations have been suggested. However, because of resistant Neisseria gonococcus strains, many centers still use silver nitrate.

Credes Prophylaxis
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