How Gonorrhoea Causes Blindness

By Elizabeth Ujay. MBBS in view, Freelance Volunteer Health Writer.. Medically reviewed by: A. Odutola, MB.BS., PhD.

September 28, 2025.

A newborn with Ophthalmia Neonatorum showing yellowish discharge from the eyes as a result of gonococcal eye infection.

Key Takeaways

• Gonorrhoea is a sexually transmitted infection (STI) that can have serious consequences, including blindness. 

• Although the condition is often associated with genital symptoms, it can also infect the eyes, leading to an eye infection of the newborn (otherwise medically referred to as gonococcal Ophthalmia Neonatorum) and adults (otherwise medically referred to as gonococcal conjunctivitis). 

• Gonorrhoea disease of the eyes if left untreated or poorly treated, can cause the cornea (the transparent part over the eye) to ulcerate (i.e., develop a painful sore) and even perforate (i.e., form a hole in) the globe of the eye, which can ultimately result in blindness. 

• Gonorrhoea disease of the eyes is preventable and readily treatable with antibiotics. Early treatment produces the best results without complications.

Introduction

When we think of gonorrhoea, we often associate it with symptoms such as painful urination and unusual discharge. However, many people are unaware of the potential link between gonorrhoea and blindness. This connection is essential to understand, as it highlights the far-reaching impact of this common sexually transmitted infection. [1, 2]

This article explains how gonorrhoea is transmitted, its effects on the eyes, and preventive measures that you can take to protect your eyes against this harmful infection.

What is Gonorrhoea?

Gonorrhoea, informally known as¨ the clap ¨ or ¨the drip, ¨ is an infection caused by a bacterium or germ, known as Neisseria Gonorrhoeae [1]. It is primarily a sexually transmitted infection, but it can also be transmitted from mother-to-child through exposure of the baby to the purulent discharge in an infected mother’s birth canal during childbirth. Gonorrhoea infects moist surfaces, most of which are the urethra, anus, throat, and eyes. [2]

How is gonorrhea transmitted?

Gonorrhoea can be transmitted through the following ways

1. Through unprotected sexual contact, including vaginal, oral, or anal sex.

2. Through the use of infected sex toys not covered with a condom during use.

3. From mother-to-child during childbirth. [4]

General Symptoms of Gonorrhoea

People infected with gonorrhoea may not show any symptoms. 

About 10% of men and 50% of women infected do not show symptoms. However, if they do, symptoms will depend on the site infected and the individual's sex. [3]

In women, Symptoms include:

• Vaginal discharge: This is the most common symptom. Discharge is thin, contains pus, and may be slightly odorous.
• Painful urination
• Painful sexual intercourse
• Lower abdominal pain
• Bleeding between menstrual periods

In men, symptoms may include 

• Burning sensation during urination
• Penile discharge (fluid from the opening of the penis): discharge is initially clear and tiny, but a few days later becomes profuse, with pus, and may be blood-stained. 

If the rectum is infected, both males and females may experience pain and tenesmus (a feeling of urgent bowel movement). Gonorrhoea can also cause a systemic or general body infection when it spreads from its primary site. This is called a Disseminated (or Widespread) gonococcal infection. This condition affects joints and tendons, and patients usually have joint pain [4].

Gonorrhoea and the Eyes

Neisseria gonorrhoea can cause an eye infection when it comes in contact with the eye. Gonococcal eye infection is more common in babies, mainly during delivery from their mother. It causes gonococcal Ophthalmia Neonatorum, a type of infection affecting the eyes of children during the neonatal period or early period of life. 

• Eye Infection in Babies

Ophthalmia neonatorum may also be caused by other germs like. Chlamydia trachomatis, Herpes simplex virus, Staphylococcus aureus, etc.

In a study carried out in Nairobi, Kenya, it was found that out of 149 babies screened for the cause of Ophthalmia Neonatorum, 64 (43%) was caused by Neisseria gonorrhoeae. [3]

• Eye Infection in Adults

Adult eye infections are also increasing, predominantly among teenagers and young adults. The mode of transmission is mainly from auto-inoculation (self-contamination) of the eyes from genital infections [2]. 

A dangerous superstition played a role in an African country in the tragic case of a woman with glaucoma. She used her urine to wash her eyes, believing it would relieve her symptoms. Unknown to her, she was also infected with gonorrhoea. Unfortunately, due to a delay in disclosing this information to her doctors, the infection progressed, leading to irreversible vision loss.

How Gonorrhoea Causes Blindness

Here are the steps through which the bacteria causing gonorrhoea can cause blindness:

• Infection
• Inflammation
• Ulceration
• Perforation

When the Neisseria gonorrhoeae bacteria enters the eye; it infects the thin tissues covering the eyes lids (conjunctiva) to cause gonococcal conjunctivitis in adults and Ophthalmia Neonatorum in infants.

The infection results in inflammation, which is a general reaction of the body to injury, infection, or irritation. The conjunctival inflammation causes redness, swelling, heat, and pain in the eyeball and eyelid. It is the start of the process in the fight against invaders of the body and signals healing.

The inflammation can progress to ulceration (development of sores) of the cornea (the transparent tissue covering over the globe of the eye). This may lead to perforation of the globe, causing permanent blindness if left untreated [2].

Symptoms of Gonorrhoea infection in the Eye

The incubation period for gonorrhea (i.e., the time it takes for gonorrhoea infection to develop after you’re exposed to the bacteria (germ) is usually less than one week but may last up to 3 weeks . 

If you or your baby develops a gonorrhoea eye infection, the following symptoms are likely to occur:  

1. Swelling around the inner eyelids of the eye occurs mainly 2-5 days after birth in the case of a baby, or also 2-5 days after eye infection in adults
2. Red eyes
3. Watery or thick discharge from the eye
4. Increased sensitivity to touch or pressure around the eyes
5. Increased sensitivity to light

Prevention of Gonorrhea Eye Infection

In the Newborn

• Antenatal screening and Treatment: Pregnant women should be screened for sexually transmitted infections (STIs), so that asymptomatic women can be detected and treated before delivery.

• Doctors, midwives, and nurses should maintain strict and good hand hygiene practices in delivery suites.
• Routine neonatal prophylaxis (i.e., application of erythromycin ointment to the eyes) should be given immediately after birth as it is the cornerstone of prevention.

In the Adult

• Prompt treatment of genital gonorrhea helps prevent autoinoculation to the eye.

• Maintain and practice good hygiene practices. Avoid touching your eyes after genital contact.

• Practice safe sexual practices like the use of condoms, which helps to reduce the risk of ocular exposure.
  
   

Treatment of Gonorrhoea Eye infection

In the Adult:

• Gonococcal eye infection is treated with antibiotics. Standard guidelines of treatment include the use of antibiotics called ceftriaxone that are usually administered intramuscularly and jointly with another class of antibiotics (azithromycin or doxycycline) orally to treat co-infections that are usual with gonorrhoea infection. 

• Supportive care of the eyes with regular sterile saline wash helps to remove eye discharge.

• Symptoms should resolve within a few days with effective treatment. [7]

Early diagnosis and treatment will determine if there will be a complete recovery. Also, previous treatment of gonorrhea does not confer immunity.

In the Newborn:

• Gonococcal eye infection in the newborn is also treated with similar antibiotics as in adults, but at different dosage. In a special condition, when a high level of a substance called bilirubin is present in the blood of the newborn, a different type of antibiotic is used. 
• The antibiotics are administered intramuscularly (into the muscle) or intravenously (into a blood vessel). 
• Supportive care of the eyes with regular sterile saline wash also helps to remove eye discharge.
• The use of antibiotic eye drops alone to treat gonorrhoea infection of the eyes in newborn babies is not sufficient and not advised.

Gonorrhoea eye infection is considered a medical emergency. So, it is important to consult with your healthcare provider as soon as you notice symptoms in yourself or a baby. Do not self-treat a gonorrhea eye infection as the risk of eye damage and blindness is very high. 

Also be mindful that the bacteria causing gonorrhoea eye infections, Neisseria gonorrhoeae have developed antibiotic resistance to many of the older antibiotics. Therefore, standard of care guidelines with new generation antibiotics must be used for treatment to be effective 

Conclusion

Gonorrhoea is a common sexually transmitted disease caused by Neisseria gonorrhoeae. The bacteria can also cause eye infections in children (Ophthalmia Neonatorum) and in adults (gonococcal conjunctivitis). If not treated early, the bacteria can cause corneal inflammation, ulceration and perforation of the globe, leading to permanent blindness. Good hygiene, treatment of infected pregnant women, and the use of condoms during sexual activities can help prevent the spread of this infection. Early diagnosis is also very important to avoid serious complications that may lead to blindness.  

References

1. Qureshi S. Gonorrhoea: Practice essentials, background, pathophysiology [Internet]. Medscape. Updated April 23, 2025. [Cited 2025 Sep 19]. Available from here.

2. Dolange V, Churchward CP, Christodoulides M, Snyder LAS. The Growing Threat of Gonococcal Blindness. Antibiotics (Basel). 2018 Jul 12;7(3):59. doi: 10.3390/antibiotics7030059. Available from here.

3. Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D’Costa L, Brunham RC, et al. Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. J Infect Dis. 1986;153(5):862-9. doi:10.1093/infdis/153.5.862. Abstract available from here.

4. World Health Organization. Gonorrhoea (Neisseria gonorrhoeae infection) [Internet]. Geneva: WHO; 2023 Aug 22. [Cited 2025 Sep 19]. Available from here.

Related: Gonorrhoea Eye Infection in the Newborn: What Africans Need to Know

Published: September 28, 2025

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