Ever wondered why some newborns had drops put into their eyes shortly after birth?
It may look strange, but there was a serious reason behind it — protecting a baby’s vision.
What is silver nitrate?
1% silver nitrate was traditionally used as an ocular prophylactic in newborns.
Its antimicrobial action helps prevent gonococcal ophthalmia neonatorum, a potentially severe eye infection caused by Neisseria gonorrhoeae.
Why was it important?
A baby can acquire the infection during delivery from an infected birth canal.
And this isn’t just ordinary conjunctivitis.
It can rapidly cause:
• Severe swelling and discharge
• Corneal damage
• Corneal perforation
• Permanent blindness
Did it actually work?
Yes. Historical evidence shows that silver nitrate played an important role in reducing gonococcal eye infections and blindness.
But there was a downside.
Silver nitrate can cause chemical conjunctivitis — temporary redness and swelling of the baby’s eyes.
It also doesn’t reliably prevent chlamydial ophthalmia.
What about today?
This is where things get interesting.
Silver nitrate is not routinely used everywhere today. WHO lists it as one possible option for neonatal ocular prophylaxis, alongside agents such as erythromycin, tetracycline and povidone-iodine. However, WHO rates the evidence for choosing between these agents as low quality.
In India, NHM’s Universal Eye Screening in Newborns guideline also mentions 1% silver nitrate as an option, while noting that prophylaxis was recommended but not routinely practiced.
The bigger picture
The best protection actually starts before delivery.
Screening pregnant women for gonorrhoea and treating infection when detected can prevent transmission to the newborn.
So, that tiny drop wasn’t simply “routine medicine.”
It was part of an important idea in newborn care:
Prevent the infection before it gets a chance to steal the baby’s vision. 
Practices vary by country and institution. Newborn ocular prophylaxis should follow current national guidelines and hospital protocols.
MBH/PS