Corticosteroid in the Treatment of Neisseria gonorrhoeae Keratitis

Abstract

Ocular infection with Neisseria gonorrhoeae is relatively rare. We may be less suspicious of it as a result. Indeed, all four cases of corneal perforation secondary to gonococcal infection described in one case series were originally misdiagnosed as epidemic keratoconjunctivitis [1].Cases occur in sexually active individuals. Infection results from contact with infected urine and/or genital secretions. Such contact may be direct or by indirect 'autoinoculation' wherein infective genital secretions are transferred from their source to the eye's surface by hand-eye contact.Genitourinary symptoms of gonococcal infection, if they occur (up to 80% of males and 20% females affected in this regard are asymptomatic) may precede ocular symptoms by one to several weeks. Patients are howev er unlikely to make a connection between their sexual behaviour, genital and ocular symptoms. Consequently, retrieval of the pertinent patient sexual and genitourinary system history may be invaluable in suggesting a diagnosis of gonococcal keratoconjunctivitis.Neisseria gonorrhoeae causes a conjunctivitis which typically presents hyper-acutely with usually bilateral but occasionally, as