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From: (Jonathan R. Fox)
Subject: Re: Vitamin K. injection and Eye prophylaxis
Date: Thu, 02 Mar 2000 07:45:50 GMT

On Wed, 01 Mar 2000 22:40:04 -0800, (Larry
Bickford) wrote:
>2. The incidence of eye infection causing blindness following childbirth
>in an otherwise healthy birth is essentially zero. The primary rationale
>for using antibiotic prophalaxis is to prevent infection from gonerrhea,
>syphillis, and to a lesser issue, staph and pneumococus. (And, I suspect,
>to reduce the risk of hospital-borne bacterial infection.) In the absence
>of clinical infection,  we generally use a broad-spectrum medium potency
>suspension, not "eye goop" ointment. When ointment preps are used, they
>are blotted to remove excess and "visual impairment", if any, lasts a few
>minutes and by then the little one is usually asleep anyway.

The incidence of eye infection causing blindness following childbirth
is essentially zero precisely because of prophylaxis.  In 1880, 10% of
European children developed gonococcal conjunctivitis at birth, and
ophthalmia neonatorum was the leading cause of blindness.  The
following year, the use of silver nitrate reducted the incidence from
10% to 0.3%.  Currently, due to prenatal screening of mothers and the
use of prophylaxis, gonococcal ophthalmia has been passed by
chlamydial conjunctivitis in incidence.

I don't understand why you claim that gonococcal ophthalmia is no
longer a potentially blinding condition.  It still is.

Jonathan R. Fox, M.D.

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