Ocular manifestations of syphilis: recent cases over a 2.5-year period

Abstract

All patients with ocular syphilis exhibited functional improvement and resolution of ocular inflammation after a specific antibiotic treatment. As a great imitator, syphilis should be considered in all patients with uveitis, scleritis, episcleritis, or optic neuritis, especially in men with high-risk sexual behavior.

Syphilitic Scleritis

“…These increases in reported cases concern most often homosexual males and persons co-infected with HIV. 7 In our reported case, the patient had a high-risk sexual behavior with an HIV-positive man. Severe ocular manifestations of HIV are commonly seen and this could explain this atypical ocular scleritis case.…”

Corticosteroids and Anti-Complement Therapy in Retinal Diseases

“…Consultation with a specialist in infectious diseases is recommended in order to select the most current recommended treatment plan for any infectious disease that affects optic nerve function. Syphilis is well known to the ophthalmologist through the old adage that it can do anything and present with involvement of any part of the eye (Bhai and Lyons 2015;Morshed and Singh 2015;Puech et al 2010). Indeed, optic nerve involvement may be unilateral or bilateral and may present as optic perineuritis, optic neuritis, or papillitis.…”

Unilateral Nodular Scleritis Secondary to Latent Syphilis

“…4 Ocular lesions were the initial manifestations of syphilis in 87% of the confirmed cases in one published review. 5 Scleritis secondary to latent syphilis responds only minimally to steroids but demonstrates a dramatic response to penicillin therapy. Previously documented cases report full and rapid resolution of the nodules 1 to 2 weeks after the first dose of antibiotic.…”