Gonococcal conjunctivitis is pink eye that develops due to a gonorrhea infection. It’s most common in newborns who get it from their birthing parent during delivery. But adults can get it, too, if their eyes come in contact with infected fluids.

Gonococcal conjunctivitis (GC) is a form of pink eye. GC occurs when gonorrhea, a sexually transmitted bacterial infection, spreads from someone’s genitals to another person’s eyes.

GC can also happen when a person with an active gonorrhea infection gives birth. In this case, bacteria from vaginal fluids can pass the infection to the child — even during a cesarean delivery (C-section).

Read on to learn more about what causes GC, symptoms to watch out for, and what’s involved in treatment.

The bacteria Neisseria gonorrhea causes GC. It’s the most common cause of sexually transmitted gonorrhea infections.

GC is spread in two ways:

  • from infected fluids in the vagina to a baby during birth
  • from infected genital fluids, such as semen, that make contact with someone’s eyes

In newborns

When a baby passes through the birth canal, they’re exposed to the mucus-filled linings (mucosa) of the cervix and urethra. The mucosa can carry high concentrations of gonorrhea bacteria during an active infection, so it’s not uncommon for that bacteria to pass to the baby’s eyes and cause GC.

At the time of delivery, newborns receive topical antibiotics to help prevent GC. But even with this preventive measure, about 10% of babies born to a parent who has an active gonorrhea infection during birth may develop GC. This can happen even during a cesarean delivery.

In adults

GC most commonly passes between adults when bodily fluids from someone who has gonorrhea make contact with someone else’s eyes. This could happen directly, such as if ejaculated semen makes contact with your eyes. It could also occur indirectly, such as if you touch your eyes after touching infected fluids.

Experts also think you can contract GC if you touch an infected object and then touch your eyes. But this is less common because gonorrhea bacteria don’t last long after leaving the body.

Other strains of gonorrhea not linked to sexually transmitted infections (STIs) can also cause GC.

Some of the most common symptoms of GC are similar to those you might experience with other types of pink eye:

  • swelling of the inner linings of your eyelids (chemosis)
  • watery or thick discharge from your eye
  • sensitivity to touch or pressure on your eyes
  • fluid buildup around your eyelids
  • swelling of the lymph nodes near your eyes (preauricular lymphadenopathy)

Without treatment, severe or long-term cases of GC can also result in:

  • swelling in the lining around your brain and spinal cord (meningitis)
  • permanent scarring of eye tissue
  • partial or complete loss of vision (blindness)
  • dangerous blood infections (sepsis)
When to see a doctor

Seek immediate medical help if you experience any of the following:

  • fever
  • intense pain in or around your eyes
  • sudden loss of vision or hearing
  • intense headache
  • difficulty concentrating or remembering things
  • difficulty forming complete words or sentences
  • seizures

In newborns

GC symptoms usually show up when a newborn is 2 to 5 days old. A doctor will usually make a diagnosis based on a physical exam and on whether the birthing parent has a GC infection. Healthcare professionals can also quickly confirm an infection by examining a smear of eye discharge under a microscope.

Doctors in the United States typically test pregnant people for gonorrhea during the first prenatal visit. They may also test for gonorrhea during the third trimester if you are at increased risk of infection.

In adults

A doctor may consider GC if you have pink eye symptoms, even if you don’t have genital symptoms. They may ask for a sexual history and conduct other tests, including:

  • Gram stain: A gram stain first involves taking a sample of eye discharge, smearing it onto a glass microscope slide, and sending it to a lab. There, lab technicians use a special stain to highlight the gonorrhea bacteria.
  • Polymerase chain reaction (PCR) test: This involves taking a swab of eye discharge or tissue to test for the presence of DNA associated with gonorrhea.
  • STI tests: A doctor may collect a urine sample, throat swab, or rectal swab to test for gonorrhea.

Babies with GC infections need prompt treatment because they’re at much higher risk for long-term complications. Infections in adults are usually less urgent.

If you’re pregnant and believe you might have gonorrhea, get tested as soon as possible and seek treatment before you give birth. This will reduce your risk of passing the infection to your child.

In newborns

Healthcare professionals may treat newborns with GC in the hospital. Common treatments for GC in babies include:

A doctor might also recommend erythromycin or tetracycline as a preventive measure in newborns without symptoms who may be at high risk of GC.

In adults

Adults don’t usually need to go to the hospital to treat GC. A doctor or ophthalmologist might recommend treatments such as:

  • ceftriaxone injection
  • azithromycin taken by mouth, especially if you have a chlamydia infection at the same time
  • saline rinse of the eyes to clear out high concentrations of bacteria

Symptoms usually resolve less than a week after they appear, especially if you treat them right away. Untreated infections may last longer and result in long-term complications that are hard to treat.

Newborns who don’t receive timely treatment can develop sores in their cornea, the outer layer of the eye that helps focus light. Over time, this can lead to permanent visual disability.

GC is a potentially serious infection resulting from eye contact with the bacteria that cause gonorrhea. It’s most common in babies born to a birthing parent who has gonorrhea at the time of delivery.

Prompt treatment of GC is usually successful, but delayed treatment can result in long-term complications.

Be sure to consult a doctor or ophthalmologist if you notice any symptoms of GC. If you’re pregnant, talk with a doctor about your risk of gonorrhea infection.