Which clinical history findings are characteristic of ophthalmic syphilis in HIV infection?

Updated: Jun 12, 2019
  • Author: Robert A Copeland, Jr, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Ocular manifestations of syphilis can mimic any ocular inflammatory disorder. The initial presentation of ocular syphilis is unilateral with subsequent contralateral eye involvement in 50% of cases.

Ocular manifestations of syphilis vary with the stage of the disease. In the primary stage, eyelid or conjunctival chancre is present. In the secondary or tertiary stage, iridocyclitis or more diffuse intraocular inflammation is present.

Other manifestations of secondary and/or tertiary syphilis include the following:

  • Optic neuritis

  • Active chorioretinitis

  • Retinitis

  • Retinal vasculitis

  • Conjunctivitis

  • Episcleritis

  • Dacryoadenitis

  • Dacryocystitis

  • Scleritis

  • Monocular interstitial keratitis

Dissemination of the disease in secondary syphilis may be accompanied by arthralgia, headache, low-grade fever, and maculopapular rash.

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