Gonococcal-Associated Iridocyclitis (Anterior Uveitis): A Literature Review

Background. Ocular gonococcal infection in adults is rare but potentially sight-threatening due to its rapid progression and risk of corneal complications. Anterior uveitis (iridocyclitis) in the context of Neisseria gonorrhoeae is frequently underrecognised and misclassified as non-specific uveitis without consideration of an STI aetiology. Aim. To summarise current evidence on the clinical spectrum, diagnostic approach, and treatment principles of gonococcal-associated anterior uveitis/iridocyclitis. Materials and methods. A narrative literature review was conducted using PubMed/PMC databases (1987–2026). Search terms: Neisseria gonorrhoeae, gonococcal, ocular, uveitis, iridocyclitis, anterior chamber reaction. Inclusion criteria: laboratory-confirmed gonococcal aetiology and description of anterior segment status. Twenty-three sources were analysed. Results. Isolated gonococcal iridocyclitis is rare; uveitic signs more commonly occur as a component of severe keratoconjunctivitis. Early laboratory confirmation (NAAT or culture) and immediate systemic ceftriaxone remain the cornerstones of sight-preserving management. Conclusion. Gonococcal iridocyclitis requires a multidisciplinary approach involving ophthalmology, dermatovenereology and infectious disease specialists. Growing antimicrobial resistance in N. gonorrhoeae mandates ongoing surveillance and protocol updates.

Keywords: gonorrhea, Neisseria gonorrhoeae, iridocyclitis, anterior uveitis, keratoconjunctivitis, diagnosis, ceftriaxone.