Gonococcal Conjunctivitis

What is Gonococcal Conjunctivitis?

Gonococcal conjunctivitis (GC) is a type of bacterial conjunctivitis, or "pink eye." It's caused by the bacteria Neisseria gonorrhea and primarily affects two groups of people:

• Newborns
• Sexually active adults

GC is rare. A study conducted in two Dublin hospitals showed a prevalence of 0.19 cases per 1,000 eye emergencies.⁷ The majority of these cases occurred in young males.

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GC is most commonly associated with the sexually transmitted disease (STD) gonorrhea. If left untreated, it can lead to serious health problems.

However, GC is treatable. Early identification and treatment can decrease the risk of more severe health problems.

What Causes Gonococcal Conjunctivitis?

Unprotected sex is the primary cause of GC. Babies can contract neonatal conjunctivitis through contact with the birth canal during delivery.

Transmission may also be due to:

• Autoinoculation. When an infection in one area of the body (genitals) spreads to other areas of the same body (eyes).
• Inoculation. When a person spreads the infection to a sexual partner.

Gonococcal conjunctivitis via inoculation is a sexually transmitted infection (STI) like chlamydia or hepatitis B.

Gonococcal bacteria usually don't live for more than a few minutes outside the body.

Symptoms of Gonorrhea Conjunctivitis 

The infection has an incubation period of 3 to 19 days. This means someone may not show signs or symptoms until at least 3 days after contracting the infection.

Infection symptoms include:

• Chemosis (swelling of the conjunctiva)
• Purulent discharge (stringy, mucus-like white or yellow substance around the eyes)
• Eyelid swelling
• Conjunctival infection (red eyes) 

If someone has any of these symptoms, they should promptly consult an eye doctor. If symptoms are severe or reappearing, samples can 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 in the eye socket). Ulcerative keratitis may also occur, leading to corneal perforation.

Risk Factors of Gonococcal Conjunctivitis

Risk factors of gonococcal conjunctivitis include:

• Unprotected sex
• Wearing contact lenses (bacteria can remain on these surfaces)
• Having a compromised immune system
• Prior ocular disease
• History of STIs/STDs
• Alcohol misuse or recreational drug use

In the U.S., estimates of gonococcal conjunctivitis are not well studied. STI surveillance places the number of cases of gonorrhea at around 146 per 100,000 Americans. 

How to Treat and Manage Gonococcal Conjunctivitis

GC requires prompt antibiotic therapy. If left untreated, corneal perforation, blindness, and other severe conditions can occur.

The type of antibiotic(s) needed depends on whether the person is treated inpatient or outpatient.

High-risk cases require inpatient treatment. Medication for inpatient treatment includes:

• Cefoxitin
• Ceftriaxone
• Cefotaxime
• Spectinomycin

Outpatient antibiotics include:

• Ceftriaxone
• Azithromycin

Healthcare providers can administer antibiotic eye drops to prevent GC in newborns.

How to Maintain Good Eye Health

Prioritize maintaining good eye health when recovering from GC. This involves:

• Washing the eyelid and applying warm, wet compresses 
• Using hand sanitizers when you can't wash your hands
• Not swimming in pools
• Avoiding contact between the infected and healthy eye

Consult a medical care provider for additional tips.

Summary

Gonococcal conjunctivitis (GC) is a type of bacterial conjunctivitis. It is commonly associated with the STD gonorrohea. If you experience this condition, consult an eye doctor immediately. They'll assess your condition to determine the best treatment.