PREVENTION OF NEONATAL OPHTHALMIA: LITERATURE REVIEW OF THE USE OF SILVER NITRATE AND POVIDONE-IODINE

Abstract

Neonatal ophthalmia is an eye infection that can affect newborn babies, usually caused by peripartum vaginal exposure to infectious agents such as Neisseria gonorrhoeae, Chlamydia trachomatis or Herpes simplex virus 1, for example. This disease is more prevalent in developing countries with a high rate of sexually transmitted infections (STIs), especially where prenatal care is poor. However, the prevention of neonatal ophthalmia with the use of antimicrobial eye drops has dramatically reduced the incidence of conjunctivitis and serious complications such as blindness. Against this backdrop, in view of the problems related to neonatal ophthalmia, which sometimes causes irreparable damage to neonatal eye health, as well as its ease of prevention, this study is justified. Its aim is to analyze the use of silver nitrate and povidone-iodine in the prevention of the disease, assessing the benefits and risks associated with the eye drops and their current eligibility. To this end, original and review articles in English, Portuguese and Spanish published over the last 22 years were collected from the main bibliographic databases, such as SciELO, PubMed and Google Scholar, in order to ensure greater reliability of the data. Prevention with antimicrobial eye drops has proved fundamental in reducing cases of neonatal ophthalmia and serious complications, such as blindness, since the discovery of silver nitrate, which had broad coverage against Neisseria gonorrhoeae. However, this substance began to have considerable adverse effects, such as chemical conjunctivitis, as well as not proving effective in covering the other pathogens involved in the genesis of the disease, which made it necessary to look for alternative eye drops. In this scenario, povidone-iodine was discovered, which is currently considered the first choice in the prevention of neonatal ophthalmia, guaranteeing coverage against the other pathogens that cause conjunctivitis, being more accessible, low-cost, widely available and without the adverse effects of silver nitrate. This, in addition to giving povidone iodine greater efficacy and safer application, makes it possible to reach a wider population, allowing low and medium development countries, or regions with more precarious health conditions, to have access not only to preventive measures, but also to universal eye health for the pediatric age group.