Introduction Ocular syphilis is a sight-threatening condition. It can occur at any stage of syphilis infection, which present either with acute inflammation during the primary, secondary, and early latent stages or with chronic inflammation during tertiary infection, affecting virtually every ocular structure. This study was to report on the clinical presentation of ocular syphilis that presented to eye clinic Hospital Universiti Sains Malaysia. Methodology This was a retrospective study where medical records of ocular syphilis patients who attended eye clinic in Hospital Universiti Sains Malaysia from January 2013 to June 2017 were reviewed. Results A total of 10 patients (13 eyes) with ocular syphilis were identified out of 106 cases that presented with ocular inflammation. The mean age of presentation was 69.8 ± 6.4 years and seven of them (70%) were female. All patients were Malay and human immunodeficiency virus (HIV) was negative. The ocular manifestations included panuveitis (four eyes, 30.8%), anterior uveitis (two eyes, 15.4%), posterior uveitis (seven eyes, 53.8%) and optic neuritis (two eyes, 15.4%). Seven (53.8%) eyes presented with visual acuity of worse than 6/60, five (38.5%) eyes had visual acuity between 6/15 to 6/60, and one (7.7%) eye had visual acuity of 6/12 or better. Nine patients received an intravenous benzylpenicillin regime and one patient received an intramuscular penicillin injection. Out of 13 eyes affected, 11 (84.6%) eyes had improved visual acuity of at least one Snellen line after treatment. Visual acuity of 6/12 or better increased to four (30.8%) eyes. Conclusions Posterior uveitis was the commonest presentation of ocular syphilis in HIV-negative patients. Early detection and treatment of ocular syphilis can result in resolution of inflammation and improvement of vision.

Ocular injury remains a potential hazard to motorcyclists. While the incidence of traumatic penetrating or blunt ocular injury is widely known in the literature, ocular injuries due to insect hair or spine (ophthalmia nodosa) among motorcyclists are scarce or unheard of. Here, we report four cases of ocular injuries caused by insect hair spines among motorcyclists. Patients consist of three males and one female with ages ranging from 18 to 24 years. All patients presented with unilateral ocular irritation after a history of insect entry into the eye while riding a motorcycle. Visual acuity upon presentation ranged from 6/6 to 6/60. Penetration of setae into the cornea and anterior chamber reaction was found in all patients. Complete removal of cornea setae was not possible in all patients. Immediate treatment with topical antibiotics and corticosteroids was administered and continued for one to three months. All patients recovered well attaining a vision of 6/6 to 6/9. In conclusion, ophthalmia nodosa among motorcyclists is a preventable ocular hazard with the appropriate use of a visor or protective eyewear. Immediate treatment may prevent severe ocular complications.

Tze-Suen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Hearing loss is rarely associated with sympathetic ophthalmia. We describe a young man who presented with sympathetic ophthalmia and concurrent hearing loss one month post globe rupture. The presentation was very subtle and atypical. However, the patient recovered fully after two weeks of prompt oral corticosteroid therapy which resulted in good visual and hearing outcomes. This patient demonstrated that the acute phase of sympathetic ophthalmia is reversible with early recognition of features, timely diagnosis, and rapid initiation of corticosteroid therapy.

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