Gonococcal conjunctivitis (GC) is a type of bacterial conjunctivitis, or "pink eye." Pink eye is an eye infection caused by a bacteria or virus.
GC is caused by a bacteria (the gram-negative diplococcus Neisseria gonorrhoeae). It usually affects two groups of people:
This infection is rare. One study conducted in two specialist Dublin hospitals showed a prevalence of 0.19 cases per 1000 eye emergency attendees. The majority of these cases occurred in young males.
In the first image, you'll see discharge and swollen red eyelids. The patient had a hard time opening their eyes. The second image was taken 3 days after treatment. Discharge and swelling are reduced but still not disappeared. Source
GC is most commonly associated with the STD gonorrhea. It is transmitted through contact with infected genital secretions or urine. Newborns can get it from the birth canal.
Inclusion conjunctivitis is another form of pink eye caused by Chlamydia trachomatis. Doctors will often test to see if patients have coexisting gonorrheal and chlamydial infections.
If left untreated, GC can lead to serious health problems. For example, gonococcal conjunctivitis may scar the conjunctiva. This scarring can result in irregularities in the tear film.
In other cases, this type of conjunctival infection may spread to the cornea and contribute to blindness or even lead to systemic infections like meningitis.
However, gonococcal conjunctivitis is treatable. Early identification and effective management can lessen the risk of unwanted health problems, such as vision loss.
Gonococcal conjunctivitis (GC) is caused by contact with N. gonorrhoeae-infected urine or genital secretions.
Neonatal conjunctivitis of this kind may occur during birth delivery.
For all other individuals, this type of transmission may be due to two reasons:
Gonococcal conjunctivitis via inoculation is a sexually transmitted infection (STI) like chlamydia or hepatitis B.
The bacteria N. gonorrhoeae will not usually live longer than a few minutes when outside the body.
Lastly, some evidence has suggested that different strains of gonococci unrelated to STIs may cause gonococcal conjunctivitis.
A gonococcal infection has an incubation period of 3 to 19 days. This means that individuals may not show signs or symptoms of the infection until at least three days have passed from the time of transmission.
Urethral symptoms will usually occur first. These are followed by ocular sysmptoms for about one to several weeks.
When individuals have gonococcal conjunctivitis, symptoms can quickly progress. Some symptoms of this ocular infection include:
If someone has any of these symptoms, they should schedule a consultation with an eye doctor immediately. If symptoms are severe or reappearing, samples of infected secretions may be tested in a laboratory for confirmation.
When the infection is severe, general health can worsen. For example, swelling of the eyelids may restrict eye movements. This may cause a misdiagnosis of orbital cellulitis (infection of the soft tissue and fat that maintains the eye in the socket). Ulcerative keratitis may also occur, leading to corneal perforation.
A delay in diagnosing gonococcal conjunctivitis may happen because genitourinary symptoms are subtle or absent.
Different risk factors exist for gonococcal conjunctivitis, including:
In the United States (U.S.), specific estimates of gonococcal conjunctivitis have yet to be well studied. STI surveillance places the number of cases of gonorrhea at approximately 146 per 100,000 U.S. inhabitants.
Gonococcal conjunctivitis requires prompt antibiotic therapy. Disease severity at the time of treatment can influence the outcome of the infection.
When gonococcal conjunctivitis is not appropriately treated, it can cause corneal perforation, blindness, and other severe medical conditions.
Less severe cases in adults may be treated on an outpatient basis with antibiotics ceftriaxone and azithromycin.
High-risk cases may require hospitalization and treatment with antibiotics such as cefoxitin, ceftriaxone, cefotaxime, or spectinomycin.
Health care providers administer silver nitrate eye drops or topical erythromycin ointment to prevent conjunctivitis in neonates.
Additionally, individuals with gonococcal conjunctivitis can take some steps to maintain good eye health and ensure a faster, safer recovery. Some examples include:
In any case, it is always best to consult a medical care provider.
Belga S;Gratrix J;Smyczek P;Bertholet L;Read R;Roelofs K;Singh AE; Gonococcal Conjunctivitis in Adults: Case Report and Retrospective Review of Cases in Alberta, Canada, 2000-2016. www.pubmed.ncbi.nlm.nih.gov/30044333/.
Costumbrado, John. Gonococcal Conjunctivitis. 14 Sept. 2020, www.ncbi.nlm.nih.gov/books/NBK459289/.
Lee, J S, et al. Gonococcal Keratoconjunctivitis in Adults. 27 Aug. 2002, www.nature.com/articles/6700112.
Roat, Melvin I. “Infectious Conjunctivitis - Eye Disorders.” Merck Manuals Consumer Version, Merck Manuals, Dec. 2019, www.merckmanuals.com/home/eye-disorders/conjunctival-and-scleral-disorders/infectious-conjunctivitis.
“Sexually Transmitted Diseases (STDs).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Oct. 2019, www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/doctors-departments/ddc-20351248.