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All About Gonococcal Conjunctivitis

Most people are familiar with conjunctivitis as a common eye condition that involves the inflammation and infection of the conjunctiva or the membrane lining the eyelids. Some people know it as pink eye because it involves redness of the eye. However, very few people know that conjunctivitis may also be sexually transmitted. Here is a discussion on how this is possible.

Gonococcal conjunctivitis is a contagious sexually transmitted ocular disease that is also referred to as hyperacute conjunctivitis. It has an incubation period of two to seven days.


This condition is caused by the infectious organism Neisseria gonorrhoeae which is a gram negative and intracellular diplococcus. This organism can invade an intact mucosal membrane. It can also penetrate an intact corneal epithelium which increases the risk of ulceration and corneal infection.


This condition may be obtained from the following:

•    Sexual contact
•    Casual interaction with infected persons
•    Infection of the cervix, rectum and urethra
•    A newborn may acquire this if he passes through his mother’s infected birth canal.


The following symptoms may be observed if you are suffering from this condition:

•    In some cases, patients do not exhibit symptoms.
•    Severe purulent discharge from the affected eye may be observed.
•    Eye irritation
•    Foreign body sensation inside the eye
•    Red eye
•    Affected eye may be difficult to open due to the sticky discharge.
•    In severe cases, peripheral subepithelial corneal infiltrates may be present which can result in marginal ulceration with anterior uveitis.
•    The following may also be present: superficial punctate keratitis, marked chemosis, hemorrhagic conjunctivitis, preauricular lymph nodes, conjunctival papillae and true membrane formation.

Detection and Treatment

This condition may be addressed as follows:

•    If you suspect that you suffer from this condition because you exhibit the symptoms listed above, you should immediately have your eye checked. Your doctor can perform a conjunctival scraping for culture and sensitivity testing.

•    To treat the gonococcal infection, hospitalization is recommended. You should be given one gram of ceftriaxone intravenously within 12 to 24 hours. Upon discharge from the hospital, your doctor may prescribe the following medications that you may take orally: 250 to 500 mg tetracycline taken four times a day, 100 mg doxycycline taken twice a day or 250 to 500 mg erythromicin taken four times a day.

•    To treat your gonococcal conjunctivitis, you should start with a saline lavage in order to clear and remove the mucopurulent debris from your conjunctiva and eyelids. If you suffer from corneal infection as well, a topical fluoroquinolone such as ciprofloxacin or ofloxacin may also be prescribed. Note, however, that this condition does not usually respond to topical antibiotics.

•    Your doctor should monitor your condition closely. He should do this everyday, if possible, until he can observe consistent improvement. Remember that this condition is contagious and it can likely infect your partner. You should consult your doctor for advice on dos and don’ts for persons suffering from gonococcal conjunctivitis.

About the Author

Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He is currently a Senior Lecturer there and regular speaker to both Optometrists and Ophthalmologists in Australia and Internationally. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings.

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