Ophthalmia neonatorum, also known as neonatal conjunctivitis, can also be caused by other bacteria, viruses, and chemical irritants (such as silver nitrate). Thus, silver nitrate is not used commonly anymore, because it can cause chemical conjunctivitis, which usually clears up within 2 to 4 days. In most countries neomycin and chloramphenicol eye drops are being used instead.
Ophthalmia neonatorum due to gonococci (Neisseria gonorrhoeae) typically manifests in the first 5 days of life and is associated with marked bilateral purulent discharge. In contrast, conjunctivitis secondary to infection with chlamydia (Chlamydia trachomatis) produces conjunctivitis after day 3 of life, but may occur up to 2 weeks after delivery. Babies infected with chlamydia may develop pneumonitis (chest infection) at a later stage (range 2 weeks - 19 weeks after delivery). Infants with chlamydia pneumonitis should be treated with oral erythromycin for 14 days.
Erythromycin eye drops used for N. Gonnorhea conjunctivitis do not protect against chlamydial conjunctivitis.
Gonococcal infection in eyes is uncommon now a days but very serious. Quinolone topical antibiotic eye drops are effective. 10% sulphacetamide may be a good alternative.