less inflamed. Babies infected with chlamydia may develop pneumonitis (chest infection) at a later stage (range 2–19 weeks after delivery). Infants with chlamydia pneumonitis should be treated with oral erythromycin for 10–14 days. Diagnosis is performed after taking swab from the infected conjunctivae. Prevention Antibiotic ointment is typically applied to the newborn's eyes within 1 hour of birth as prevention against gonococcal ophthalmia. This may be erythromycin, tetracycline, or rarely silver nitrate or Argyrol (mild silver protein). Treatment Prophylaxis needs antenatal, natal, and postnatal care. Antenatal measures include thorough care of mother and treatment of genital infections when suspected. Natal measures are of utmost importance, as most infection occurs during childbirth. Deliveries should be conducted under hygienic conditions taking all aseptic measures. The newborn baby's closed lids should be thoroughly cleansed and dried. If the cause is determined to be due to a blocked tear duct, gentle palpation between the eye and the nasal cavity may be used to clear the tear duct. If the tear duct is not cleared by the time the newborn is 1 year old, surgery may be required. Postnatal measures include: Use of 1% tetracycline ointment, 0.5% erythromycin ointment, or 1% silver nitrate solution (Credé's method) into the eyes of babies immediately after birth Single injection of ceftriaxone IM or IV should be given to infants born to mothers with untreated gonococcal infection. Curative treatment as a rule, conjunctival cytology samples and culture sensitivity swabs should be taken before starting treatment. Chemical ophthalmia neonatorum is a self-limiting condition and does not require any treatment. Gonococcal ophthalmia neonatorum needs prompt treatment to prevent complications. Topical therapy should include: Saline lavage hourly until the discharge is eliminated Bacitracin eye ointment four times per day (because of resistant strains, topical penicillin therapy is not reliable, but in cases with proven penicillin susceptibility, penicillin drops 5000 to 10000 units per ml should be instilled every minute for half an hour, every five minutes for next half an hour, and then half-hourly until the infection is controlled.) If the cornea is involved, then atropine sulfate ointment should be applied. The advice of both the pediatrician and ophthalmologist should be sought for proper management. Systemic therapy: Newborns with gonococcal ophthalmia neonatorum should be treated for 7 days with ceftriaxone, cefotaxime, ciprofloxacin, or crystalline benzyl penicillin. Other bacterial ophthalmia neonatorum should be treated by broad-spectrum antibiotics drops and ointment for 2 weeks.