Gonococcal conjunctivitis, caused by Neisseria gonorrhoeae, occurs in 2 distinct groups: neonates and sexually active individuals. Transmission usually occurs by contact with infected urine or genital secretions. The disease presents as a hyperacute follicular conjunctivitis with lid edema, chemosis, hyperemia, and copious mucopurulent discharge. In neonates, the infection usually begins 24-48 hours after birth but may take slightly longer. In adults, the incubation period is 2-7 days. In both, rapid diagnosis and treatment is essential to avoid severe complications such as corneal ulceration and perforation.