[Question #6143] STI in Eye? Risk Assessment

18 months ago
Hi Doctors, thanks for all that you do. I'm a 33/M/USA, and I would appreciate your thoughts on my scenario:

On Thursday 10/10, went to a strip club with friends. Went to a private room for a dance, dancers were completely naked, etc. There was kissing and fingering, but no insertion or sex of any kind. This morning, I have found that my eyes seem to be red and itchy, with mild irritation in my testicles and increased frequency of urination. I think I know your answers after going over the forum, but how would you evaluate my risk for Chlamydia or any STI?

1. Could any vaginal fluid have gotten from the stripper to my eye, and could that cause an STI?
2. If it could cause an STI, would it come up in a standard urine culture test?
3. Because I am experiencing symptoms, should I get tested and get cleared before continuing sex with my partner?
4. If I can get an STI via transmission in my eye, could I pass it on sexually to my partner?
5. Also curious, if the stripper DID have an STI, and we DID have sex, approximately what % of the time would a one time event lead to the passing on of an STI?

I'm aware that I am not likely to have been given an STI...so maybe it is just my nerves talking!! Thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Welcome to the forum. Thanks for your question.

It sounds like you might have conjunctivitis, i..e inflammation of the superficial layer of the eye, eyelids, etc -- especially if there is redness and perhaps discharge, which may be slight, just showing up as crusting e.g. on awakening in the morning (e.g. "sand in the eye"). There are two common causes, viral infection and allergy. Viral is the best bet in view of hte dance situation you describe. By far the most common viral causes are garden variety respiratory viruses, the sort that cause common colds. These are very efficiently transmitted in crowded situations with close contacts -- think fraternity parties, and certainly events like you describe.

Could it be an STD, related to fingering etc? Almost certainly not; STDs are rarely if ever acqured by fingering or other hand-genital contact, and rarely if ever transmitted to the eyes after such contact. I can't say it's impossible, but it's extremely unlkely. Gonorrrhea, chlaydia, and herpes can cause conjunctivitis, but not chlamydia or herpes in this case -- the irritation began too soon for chlamydia and sounds like not nearly serious enough to be herpes. Also, any of these three almost always involve only a single eye, not both. So we're left with a very slim chance of gonorrhea, which also almost never involves both eyes.

As for your testicular/urinary symptoms, it is not possible these are caused by any of the infections I have mentioned. You can't get genital symptoms from STDs acquired in the mouth, throat, eyes, etc. And both urinary urgency and mild testicluar pain are typical symptoms of genitally focused anxiety, not of any infection. There is no point in urine testing: it does not detect infection elsewhere in the body.

So all things considered, I am confident no STD is the cause of your sympotms. If somehow I were in your situation, I would not hzve any STD testing, and would not even see a doctor -- expecting the symptoms to clear up on their own in a few days. 

Those comments directly answer questions 1-3.

4) If you had conjunctivall gonorrhea, chlamydia, or herpes, you could transmit it to a partner by oral sex. But you don't, so don't worry about it. In addition to not getting tested, if I were in your situation I wouldd take standard precautions against transmitting colds to my wife or other family members:  no kissing for a while, hand washing, and frequent use of an alcohol gel like purel. To the extent I helf off on sex with my wife, it would be in order to avoid kissing.

5) The transmission efficiency varies between STDs. For HIV, for example, under one chance in a thousand for each episode of unprotected sex. Probably in the same rough range for herpes. For gonorrhea and chlamydia, probably around 50% chance for any single unprotected vaginal sex exposure. These estimates are for unprotected vaginal sex in presence of genital STD. The transmission chances through oral sex, from an oral STD, are far lower.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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