London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
St Pancras 1913
[Report of the Medical Officer of Health for St. Pancras, London, Borough of]
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30
OPHTHALMIA NEONATORUM.
This disease is an inflammation of the eyes of newly-born infants due to theinfection
of the eyes during birth.
It has been compulsorily notifiable by medical practitioners in London since
March, 1911.
Its importance is due to the fact that it is responsible for more cases of
blindness than any other single cause. Observers have found that more than
one-third of the inmates of blind asylums owe their blindness to an attack of
this disease in the first few days of their life.
The disease is largely preventible by proper treatment of the eyes
immediately after birth, and even when it has developed, early and skilful
treatment will generally avoid permanent damage to the eyes. The object of
the notification of the disease is to secure that such treatment shall be obtained.
23 cases of this disease have been notified during the year.
In addition to these notified cases information has been received from the
Medical Officer of Health of the London County Council in respect of four
other cases of inflammation of the eyes in the newly-born. The information in
these cases was received from registered midwives by the County Council as
the Local Supervising Authority under the Midwives Act. They were all
true cases of ophthalmia neonatorum, though slight.
The total number of cases which have come to the knowledge of theDepartment
during 1913 was, therefore, 27, equal to an incidence rate of
4'90 per 1,000 births. Other numerical details will be found on pages 23-26,
The cases are classified below according as the mothers were attended at
birth by doctors, midwives, or medical students (in their own homes), or were delivered in hospital: —
| Attended at birth by | Cases of Ophthalmia Neonatorum. | Total number of births notified. | No. of cases per 1000-births notified. |
|---|---|---|---|
| Doctors | 13 | 1857 | |
| Midwives | 7 | 1434 | 5 |
| Medical Students | 1 | 1184 | 0-9 |
| Delivered in Lying-in Hospitals | 4 | .. | |
| ,, Workhouse | 2 | .. | .. |
| 27 | .. | .. |
It will be seen from these figures that ophthalmia neonatorum was more
prevalent in the practice of doctors and midwives than in that of the extern
midwifery "charities" of the hospitals (University College, Royal Free and
Middlesex) which send out medical students. This fact was pointed out by
Miss Smith in last year's report. At these hospitals it is a definite instruction
that a silver nitrate solution be dropped into the eyes of the new-born in
everv case. This is not a usual custom amongst doctors and midwives. It
should be noted that the midwife cases include those of the midwives sent out
by University College Hospital, who also use the silver nitrate method, so that
the percentage of ophthalmia cases amongst midwives may thus be lessened.
* The custom in the University College Hospital extern practice is to droit a 0*5 per cent. sol. of AtjNC)
into the eyes soon after birth. The lioyal Free Hospital practice is to use a 1 per cent, solution in
the same way. At the Middlesex Hospital the eyes are swabbed with 1 in 1000 HgCh, anil
painted next day with 2 per cent. sol. of Ay NO 3