Dilemmas: Eye Problems in the Newborn

Abstract

Eye problems are not uncommon in newborn infants, as in children of all ages. An extra burden is placed on the pediatrician examining the newborn for eye disease because the examination is difficult, infants being uncooperative, their periocular tissues being frequently swollen for the first few days of life, and their being incapable of keeping their eyes open and fixated or still for examination. Nevertheless, it is important that their eyes be examined properly, since some diseases if not identified and treated early can result in a lifetime of vision loss or even blindness. In some states in the United States, a newborn eye examination is mandatory. The following material will discuss the technique of proper eye examination for the newborn’s eyes and will present common instances that may be encountered in any pediatric practice that includes neonatal care. The material presented will cover the most common problems to be found in routine neonatal examination.

Consideration is given to how to go about examining the eyes of a neonate. Scenarios are considered, all common problems in neonatal ophthalmology, include absence or inequality of the red reflex, discharge from the newborn’s eyes, clouding of the cornea, and misalignment of the neonate’s eyes, including the major entities of the differential diagnosis for each finding.