Snap Shot On the 4th day of life a neonate is noted to have bilateral eye discharge. Chemical Irritation Most common cause in the first 24 hours Gonococcal Ophthalmia Presents as a purulent conjunctiviits approximately 2-3 days after birth, or up to 21 days if erythromycin prophylaxis is given Recommended standard prophylaxis given immediately after birth includes erythromycin ointment, topical tetracycline, silver nitrate, or povidone-iodine IM ceftriaxone needed once infection has occurred Chlamydial conjunctivitis Most common infectious cause of ophthalmia neonatorum Occurs 5-23 days after birth Oral erythromycin needed once infection has occurred