Gonorrhea in the eye, medically termed gonococcal conjunctivitis or ophthalmia neonatorum in newborns, is a severe bacterial infection caused by Neisseria gonorrhoeae. While commonly associated with sexually transmitted infections in the genital tract, this bacterium can also infect the eyes. This highly contagious eye infection can lead to significant complications and permanent vision damage if not addressed promptly.
Recognizing Symptoms
Ocular gonorrhea presents with distinct visual signs that typically appear rapidly, often within one to five days after exposure, though symptoms can emerge as early as 12 hours or as late as a month. The eye usually exhibits marked redness, particularly in the conjunctiva, the membrane covering the white part of the eye and lining the inner eyelids. This redness is often accompanied by significant swelling of the conjunctiva, a condition known as chemosis, and pronounced eyelid swelling.
A hallmark symptom of ocular gonorrhea is the copious, pus-like discharge that can be white, yellow, or greenish in color. This discharge is often so abundant that it quickly reforms even after being wiped away, and it can cause the eyelids to stick together, making it difficult to open the eyes, especially in the morning. Beyond these visible changes, individuals may experience eye pain, tenderness to the touch, a sensation of a foreign body in the eye, increased sensitivity to light, or photophobia, and blurred vision.
How Ocular Gonorrhea is Contracted
Ocular gonorrhea primarily results from the direct transfer of Neisseria gonorrhoeae bacteria to the eye. In adults, this typically occurs through direct contact with infected genital secretions, such as semen or vaginal fluids. For instance, if an individual touches their own or a partner’s infected genital area and then touches their eyes, the bacteria can be transferred.
A common route of transmission is from an infected mother to her newborn during childbirth. As the baby passes through the birth canal, they can come into contact with Neisseria gonorrhoeae bacteria present in the mother’s vaginal secretions, leading to gonococcal ophthalmia neonatorum. This can occur even during a C-section, as the bacteria can reside in the cervix and urethra. Practicing safe sex and maintaining good hygiene, such as handwashing after contact with genital areas, are important measures to reduce the risk of transmission.
Seeking Diagnosis and Treatment
Prompt medical attention is very important if ocular gonorrhea is suspected, as delayed treatment can lead to severe complications, including permanent vision loss. A healthcare professional will conduct a medical examination and typically take a sample of the eye discharge for laboratory testing. This sample is examined under a microscope for the presence of Neisseria gonorrhoeae bacteria, and a culture may be grown for a definitive diagnosis.
Treatment for ocular gonorrhea usually involves antibiotics. For adults, a single intramuscular injection of ceftriaxone, often combined with oral azithromycin, is a common approach. Newborns with gonococcal ophthalmia neonatorum may receive antibiotic eye ointments or injections of cephalosporins, along with hourly saline rinses to clear discharge.