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How STIs can lead to eye diseases

Do you know STDs can infect the eyes as well?
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We often hear of sexually transmitted diseases (STDs) causing symptoms in the genital region, mouth, and throat areas. But do you know STDs can infect the eyes as well?

This article strives to increase awareness of eye diseases that can be related to STDs and encourage one to cast a broader net of medical differentials in the event of unresolved eye symptoms, considering early screening and prompt treatment for any underlying sexual infections.

STD eye infection
Unresolved eye infections may be linked to sexually transmitted diseases.

Why is the eye susceptible to STDs?

STDs tend to affect the areas of the body that are relatively thin. This includes mucosal surfaces such as the genital regions (urethral, vaginal, anal), the oral (lip, mouth, throat) region, and the eyes. As the mucosal areas are very thin and delicate, physical sexual intercourse predisposes one to a disrupted skin barrier, surface abrasion and cuts, which all, in turn, increase the transmissibility of bacteria and viruses – such as STDs.

STDs in the eyes are less common compared to symptoms in the genital region or the throat. Less commonly, in some developing countries, STDs of the eyes can be seen in babies or newborns from untreated infective pregnant mothers. The eyes are indispensable organs. Untreated STDs in the eyes can lead to eye inflammation or, in severe cases, even blindness.

What are the types of STDs that can cause eye symptoms?

STDs that are associated with eye symptoms include HIV, syphilis, chlamydia, gonorrhoea, herpes simplex virus, and hepatitis virus.

STDs and abnormal eye symptoms

Eye diseases secondary to STDs are usually due to direct transfer of the STDs infection through eye contact with the genital fluid (vaginal fluid/semen fluid) or through touching/rubbing of the eyes after touching the infected private areas.

Certain STDs, such as HIV, syphilis, and hepatitis virus, can be acquired through unprotected infected sexual contact, body fluid, needle or syringe sharing or blood transfusion, leading to predisposition of eye symptoms. 

STDs associated with eye symptomsEye structure affected Eye symptoms
Chlamydia, GonorrhoeaConjunctiva (Outer layer of the eyes)Cornea (ulceration)Eye discomfortRed eyesSticky eye dischargeRecurring tearing/watery eyesVision blurrinessEye painPermanent blindness
HIVRetina (can be due to HIV or HIV-related viruses such as cytomegalovirus, zoster virus, etc.)Conjunctiva (Kaposi Sarcoma)Blurry visionsRed eyesFloatersReduced vision acuitiesBlindness
SyphilisAny part of the eyeCommonly affects the uveaReduced vision acuityBlack spots in the visual fieldCan turn blind
Herpes Simplex VirusCorneaRetinaReduced visionEye PainBlindness
Hepatitis BSclera (due to jaundice from chronic liver inflammation)Optic (eye) nerveRetina blood vesselsVision deteriorationBlindness
Pubic Lice (Pthirus pubis)EyelashesIntense itchVisible ‘crab’ crawling on the hair lashes
HPV (Human Papilloma Virus)ConjunctivaWart (Papilloma) in the eyeEye discomfortEye irritationEye dryness due to incomplete eye closure Reduced vision

Further to the above discussion, untreated infected pregnant mothers can transmit STD infections to the fetus, leading to congenital (born and permanent) blindness. Chlamydia, gonorrhoea, and syphilis infections can affect infants’ eyes through vertical transmission from untreated mothers.

STD infection baby
Untreated STD infections can pass onto newborns from infected mothers.

What are the eye symptoms that I should be worraboutSTDs?

If you have an abnormal eye symptom that did not resolve for 1-2 days and have a history of exposure to STD, you are advised to see a doctor.

Symptoms that are worth checking with your doctor include:

  • Red or pinkish colour noted over the ‘whites’ of the eye
  • Eye discomfort/pain/grittiness
  • Itchy eyes
  • Discharge from the eyes
  • Increased tear production from the eyes
  • Crusting over the eyelids or lashes after sleeping

Most STD-related eye conditions are treatable. STD screening is vital to nail down the culprit infection, allowing your doctor to prescribe the right medication without further delay. Delay of treatment may potentially lead to chronic inflammation and scarring of the eye structure and can be associated with deteriorated vision acuity and blindness.

Are eye diseases secondary to STDs treatable?

Thankfully, most of the eye diseases are treatable. Most eye diseases are treatable with eradication or management of the underlying STDs infections.

Early intervention and treatment of the underlying STD disease is paramount to prevent chronic inflammation and scarring that may lead to terminal blindness.

eye infection early intervention
Early treatment of eye infections secondary to STDs can help prevent vision loss.

Will I turn blind if I did not treat my STD-related eye disease?

This is possible if the eye infection is left unattended and the underlying STDs are not addressed, as the chronic inflammation of the eyes can lead to scarring of the eye structures, eventually leading to loss of vision.

Please seek medical help early and consider STD screening if you have concerns that your eye symptoms are abnormal and may be due to a possible STD infection.

What can I do to prevent acquiring STD-related eye diseases?

Here are some practical tips to reduce your risk of acquiring STD-related eye diseases:

  • Know your partner(s) well before delving into a sexual relationship
  • Being socially responsible to self and others- consider regular STD screening to pick up any insidious STD conditions
  • Consider using barrier contraception to reduce the risk of STD transmission
  • Work towards monogamy or decreasing the number of sexual partner(s) in a relationship to lower the risk of STDs
  • Good hand hygiene 
  • Avoid sharing personal items, including your toiletries, towels, make-up/facial products 
  • Consider HPV vaccination if you are eligible and have not done so to prevent HPV(STD)-related eye condition

To summarise:

  • STDs can affect the eyes, though they are ugh less common.
  • As the STD-related abnormal eye manifestations can be complex to differentiate clinically and treatment varies between individual STDs, it is worthwhile screening a panel of STD diseases. 
  • Most of the eye diseases secondary to STDs can be treatable if the underlying STD infection is addressed.
  • If you have a possible risk of exposure to STDs and you have unusual eye symptoms, don’t hesitate to seek medical assistance. Sometimes, there is more to meet the eyes. Do take care of your health!

References

  1. Kreisel K, Weston E, Braxton J, Llata E, Torrone E. Keeping an Eye on Chlamydia and Gonorrhea Conjunctivitis in Infants in the United States, 2010-2015. Sex Transm Dis. 2017 Jun;44(6):356-358.
  2. Hammerschlag MR. Chlamydial and gonococcal infections in infants and children. Clin Infect Dis. 2011;53:S99–102.
  3. Kumar P. Gonorrhoea presenting as red eye: Rare case. Indian J Sex Transm Dis AIDS. 2012 Jan;33(1):47-8.
  4. Lorin AB et al. Sexually transmitted infection and HIV in ophthalmology. Clin Dermatol.2023. Aug; 13:S0738-081X(23)00090-1
  5. Usui M et al. STD in the eye. Nihon Rinsho. 2009 Jan;67 (1): 107-16.
  6. Dolange V, Churchward CP, Christodoulides M, Snyder LAS. The Growing Threat of Gonococcal Blindness. Antibiotics (Basel). 2018 Jul 12;7(3):59.
  7. Paulraj S, Ashok Kumar P, Gambhir HS. Eyes As the Window to Syphilis: A Rare Case of Ocular Syphilis As the Initial Presentation of Syphilis. Cureus. 2020 Feb 14;12(2):e6998. 
  8. Khawla AS et al. The eye in sexually transmitted infections: a review of the ocular complications of venereal diseases. Int Opthalmol. 2011 Dec; 31(6):539-50.
  9. Chalkia AK, Bontzos G, Spandidos DA, Detorakis ET. Human papillomavirus infection and ocular surface disease (Review). Int J Oncol. 2019 May;54(5):1503-1510. 

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