Ocular Manifestations and Treatment of Syphilis

Abstract

Syphilis is a sexually transmitted, chronic, systemic infection caused by the spirochete Treponema pallidum. If left untreated, the disease progresses through four stages, with the potential to cause significant morbidity to any major organ of the body. Frequent syphilitic ocular manifestations, which can occur at any stage of the disease, include interstitial keratitis, anterior, intermediate, and posterior uveitis, chorioretinitis, retinitis, retinal vasculitis and cranial nerve and optic neuropathies. Diagnosis is centered around a high level of clinical suspicion and includes treponemal specific and non-treponemal serologic tests. All patients with newly diagnosed syphilis should be tested for co-infection with human immunodeficiency virus, as the risk factors are similar for both diseases. Additionally, all patients with ocular syphilis should be tested for neurosyphilis. The preferred treatment for all stages of syphilis remains parenteral penicillin G. With proper diagnosis and prompt antibiotic treatment, the majority of cases of syphilis can result in a cure.

Syphilis presenting as optic neuritis in an immunocompetent patient: Case report

“…Ocular involvement in syphilis is rare and typically occurs with secondary or tertiary syphilis (Gaudio, 2006;Kiss et al, 2005;Klig, 2008). Tamesis and Foster (1990) reported that uveitis was the most common ocular manifestation Med.…”

Common Ocular Manifestations of Sexually Transmitted Diseases

“…Almost any part of the eye may be involved in syphilis, including the sclera, cornea, lens, uveal tract, retina, retinal vasculature, optic nerve, pupillomotor pathways, and cranial nerves [15][16][17].…”

Neurosyphilis and the impact of HIV infection

“…Neurosyphilis with ocular and otologic manifestations is treated identically, although steroids may be used as an adjunctive therapy. 43,[54][55][56][57] The United States CDC, European syphilis guidelines and Canadian Public Health guidelines recommend penicillin desensitisation for penicillin allergic patients in whom ceftriaxone is not an option. 21,37,38 In patients who have improvement, resolution or stabilisation of neurological symptoms and normalisation of CSF abnormalities, treatment for neurosyphilis is deemed successful.…”