What Is Gonococcal Conjunctivitis?
Gonococcal conjunctivitis is a severe eye infection caused by the bacterium Neisseria gonorrhoeae, the same organism responsible for the sexually transmitted infection (STI) gonorrhea. This condition affects the conjunctiva—the clear membrane covering the white part of the eye and the inner surface of the eyelids.
It can occur in both newborns (known as ophthalmia neonatorum) and adults, typically through direct contact with infected genital secretions. It is a medical emergency due to its potential to cause rapid corneal damage and vision loss.
What Causes Gonococcal Conjunctivitis?
- In Newborns: Acquired during passage through the birth canal of a mother infected with gonorrhea.
- In Adults: Usually results from hand-to-eye contact with infected genital secretions or contaminated materials (e.g., towels, cosmetics).
- Sexual activity or poor hygiene are major risk factors.
What Are the Symptoms of Gonococcal Conjunctivitis?
Symptoms typically develop quickly and can become severe within 24–48 hours. Common signs include:
- Profuse purulent (pus-like) discharge from one or both eyes
- Eye redness and swelling of the eyelids (chemosis)
- Pain or irritation in the eyes
- Sensitivity to light (photophobia)
- Blurred vision
- In newborns, symptoms appear within 2–5 days after birth
How Is Gonococcal Conjunctivitis Diagnosed?
Diagnosis is based on clinical examination and laboratory tests:
- Eye swab and culture: To confirm Neisseria gonorrhoeae and rule out other organisms
- Gram stain: May show characteristic gram-negative diplococci
- NAAT (Nucleic Acid Amplification Test): For gonorrhea from eye secretions or genital sites
- Blood tests: If systemic infection is suspected
- STI screening: Often done for both the patient and sexual partners
What Are the Treatment Options for Gonococcal Conjunctivitis?
Immediate treatment is essential to prevent serious complications like corneal ulceration and blindness:
- Systemic antibiotics:
- Ceftriaxone (intravenous or intramuscular) is the standard treatment
- In neonates, a single IM dose is typically given
- Topical eye treatments:
- Saline irrigation of the eyes to remove discharge
- Antibiotic eye drops or ointments may be used alongside systemic therapy
- Hospital admission: Often necessary, especially in infants or severe adult cases
- Partner treatment: Essential to prevent reinfection
Can Gonococcal Conjunctivitis Cause Complications?
Yes, untreated or delayed treatment can lead to:
- Corneal ulceration
- Perforation of the eye
- Permanent vision loss
- Spread of infection to other parts of the body
- Neonatal blindness
How to Manage Gonococcal Conjunctivitis for a Better Quality of Life?
For Adults:
- Avoid touching or rubbing the eyes
- Seek immediate medical care at the first signs of eye infection
- Complete the full course of prescribed antibiotics
- Practice safe sex and get regular STI screenings
- Avoid sharing towels, cosmetics, or eye products
For Newborns:
- Pregnant women should be screened and treated for STIs during prenatal care
- Newborns receive prophylactic antibiotic eye drops at birth (e.g., erythromycin)
- Immediate treatment if symptoms appear