In the Ndoungué Hospital in Cameroon 449 new-born babies were examined for a month to check on the occurrence of ophthalmia neonatorum. Silver nitrate eyedrops 1% were applied at birth. The incidence of ophthalmia neonatorum was 19.4%; Chlamydia was found in 8 cases (incidence 1.8%) and gonococci in 4 cases (0.9%). Chemical conjunctivitis was suspected in 13 cases (2.9%). Slight conjunctivitis was seen in 68 cases and severe conjunctivitis in 19 cases (4.2%). A sexually transmitted agent was demonstrated in 6% of the slight cases and in 42% of the severe cases. Ophthalmia neonatorum due to Chlamydia was significantly more frequently severe and without specific features than those due to other agents. Although silver nitrate is still considered to be one of the most effective prophylactic measures for gonococcal ophthalmia neonatorum, in 4 cases this disease still developed. Silver nitrate is ineffective against Chlamydia and is also often the cause of a chemical conjunctivitis. The search is advocated for more efficient medicines in Africa which are effective against both Chlamydia and resistant gonoccoci.