RESUMEN
PURPOSE: To assess the ocular health practices within the neonatal units of the City of São Paulo, Brazil. METHODS: A questionnaire was sent to 36 neonatal units that performed 3000 or more deliveries during 2004. Data were collected on Credè's method of ophthalmia neonatorum prophylaxis, red reflex testing, retinopathy of prematurity (ROP) screening and treatment, and ophthalmic referral systems. RESULTS: All of the identified neonatal units completed the survey. Credè's method was used correctly in 31 (86%) units and the red reflex test was performed in 29 (81%) units. All units were aware of the risk factors for ROP, but the examination for its detection was executed on a routine basis in only 31 (86%) units and only 22 (61%) of the units were aware of the correct timing for the first examination for ROP. Treatment for ROP was done by the identifying hospital in 17 (55%) units and 14 (45%) hospitals transferred the neonate to an external service. After the patient's discharge, 30 (83%) neonatal units reported that they appropriately referred neonates for ophthalmic follow up. CONCLUSIONS: Prophylaxis against gonococcal conjunctivitis and the red reflex test need to be implemented more widely, tertiary referral systems need to be established in some services and the management of ROP should be improved. These recommendations may be achieved by designing and implementing guidelines around prevention and control activities to ensure that all avoidable ocular diseases are identified and managed appropriately within this vulnerable age group.