Gonococcal conjunctivitis (GC) is an eye infection caused by the bacterium responsible for gonorrhea. It can be transmitted from the person giving birth to the newborn during vaginal delivery or cesarean delivery.

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium called Neisseria gonorrhea. If a person has gonorrhea while giving birth, genital secretions may get into their newborn’s eyes. This can cause them to develop GC. When it occurs in newborns, GC may be called gonococcal ophthalmia neonatorum.

Without proper treatment, GC can lead to serious complications, such as meningitis or blindness. If a pregnant person suspects they may have gonorrhea, they should speak with a doctor about treatment before giving birth to reduce the chances of GC occurring.

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GC is a form of conjunctivitis. Conjunctivitis is an infection of the conjunctiva, which is the clear membrane that covers the surface of the eye.

GC occurs when the genital secretions from a person with gonorrhea come into contact with the conjunctiva of the eye. When Neisseria gonorrhea bacteria come into contact with the conjunctiva, they penetrate its surface and reproduce, causing inflammation.

The global infection rate of GC in newborns is less than 1%. A 2019 case study notes that GC is rare in non-newborns, but it can still occur in adults. An adult may develop GC if genital secretions containing Neisseria gonorrhea come into contact with their eyes, typically during sexual activity.

GC symptoms in newborns generally develop 2 to 5 days after birth. In adults, symptoms may develop after 3 to 19 days of contracting the infection. These symptoms may include:

  • bloodshot eyes
  • chemosis, which is swelling of the conjunctiva
  • swelling of the eyelids
  • thick, yellow or green discharge from the eye that is a mixture of mucus and pus
  • eye tenderness
  • swelling of the preauricular lymph nodes, which are located at the front of each ear

These symptoms are the same for both newborns and adults with GC.

When a person gives birth vaginally, the newborn passes through their cervix. The newborn may also come into contact with the urethra. Both of these areas may hold large amounts of bacteria.

As the newborn is pushed through the vagina, they may come into contact with certain vaginal secretions. If these secretions contain Neisseria gonorrhea, the newborn may be at risk of developing GC if they get any in their eyes. It is also possible for a newborn to contract GC if they are born via caesarean section.

An adult may contract GC if they touch their eyes after touching the genital secretions of a person with gonorrhea. They may also contract it after using items that have come into contact with secretions containing Neisseria gonorrhea, such as a towel. However, this is less likely, as the bacteria only survive for a few minutes outside the body.

A healthcare professional may diagnose a newborn with GC based on when symptoms appear. The healthcare professional may perform a physical exam of the newborn, as well as ask the person who gave birth about their sexual history and the possibility of having gonorrhea.

A healthcare professional may also take a sample of discharge from the newborn’s eye and send it to a laboratory to be tested for GC.

If a healthcare professional suspects an adult may have GC, they may ask them about their sexual history. Additionally, they may take a sample of any discharge from their eye. The healthcare professional may also test them for gonorrhea.

The Centers for Disease Control and Prevention (CDC) notes that this may involve taking a urine sample, or taking a swab from their:

  • throat
  • rectum
  • cervix
  • urethra

The best way to treat GC is to prevent it. However, if that is not possible, the CDC recommends treatment with erythromycin eye drops, an antibiotic. Doctors may also administer antibiotics intravenously or via injection.

The CDC notes that a healthcare professional should treat a newborn with GC using erythromycin as soon as possible after delivery. Additionally, they may wash the newborn’s eyes with saline every hour.

If an adult has GC, a healthcare professional may treat them using antibiotics such as ceftriaxone or azithromycin (Zithromax). They may also request that the person rinse their eyes with saline.

Undergoing screening for gonorrhea during pregnancy can help prevent GC. The CDC recommends that pregnant people under 25 years old and older pregnant people at increased risk undergo screened for STIs such as gonorrhea. This may include people who:

  • have multiple sexual partners and do not use barrier methods of protection, such as condoms
  • have a history of STIs
  • are sex workers

If healthcare professionals are aware that the person giving birth has gonorrhea, they may treat the newborn with medication to prevent GC from developing. Up to 48% of newborns born to a person with an active case of gonorrhea develop GC. Preventive medication reduces this number to 10%.

A person may reduce their risk of contracting and developing GC by:

  • washing their hands after sexual activity
  • not sharing towels with their sexual partner
  • not touching their eyes after sexual activity
  • avoiding getting genital secretions in their eyes

Without prompt treatment, GC may cause serious health issues. This may include blindness or meningitis. However, with treatment, the outlook is good for most newborns.

If a person receives treatment for the GC quickly, they may prevent the development of serious complications. It may also help to improve their chances of recovery.

A person should contact a doctor if they develop any symptoms of GC. Without treatment, GC can lead to serious health conditions. These include:

  • blindness
  • meningitis
  • scarring of the cornea, which is the clear outer layer at the front of the eye
  • ocular perforation, which is a hole in the eye
  • septic arthritis
  • septicemia

GC is a form of conjunctivitis that develops when Neisseria gonorrhea comes into contact with eye tissues. It is mostly associated with newborns. However, it may also develop in adults.

A newborn with GC may develop symptoms 2 to 5 days after birth. An adult with GC may experience symptoms 3 to 19 days after infection. Without prompt treatment, GC may cause serious health conditions such as blindness or meningitis.

Treatment for GC typically involves antibiotics and rinsing the eye with saline. A person may prevent GC by practicing safe sex.

The outlook for GC is favorable with quick treatment. If a person notices any signs of GC with or without genital symptoms, they should speak with a doctor.