What is ocular syphilis?

Updated: Jul 17, 2018
  • Author: Richard P Knudsen, MD, FAAN, FAAP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

Ocular syphilis is a new epidemic. Ocular involvement [32] often includes anterior uveitis or panuveitis (granulomatous or nongranulomatous), retinitis, retinal vasculitis, vitreitis, and papillitis. [33, 34] Symptoms of photophobia and dimming of vision obviously could develop. All symptoms can resolve with typical treatment of neurosyphilis, namely, intramuscular procaine penicillin-G. This is a relatively common manifestation of late syphilis. Adhesions of the iris to the anterior lens (synechiae) may be present, which may produce a fixed pupil; this should not be confused with Argyll Robertson pupil. Bilateral tonic pupils have been noted, with light-near dissociation and denervation hypersensitivity. A particular condition—acute syphilitic posterior placoid chorioretinitis (ASPPC)—distinct from ocular syphilis has been reported. [35] Angiographically, there is hyperfluorescence in the area of the perineuritic lesion, often with scattered focal hypofluorescence(leopardspotting). [36]


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