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Ocular syphilis - External and Internal Eye
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Ocular syphilis - External and Internal Eye

Contributors: Aditi Jani MD, Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed

Synopsis

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum (a spirochete) and is characterized by a chronic, intermittent clinical course. Treponema pallidum is transmitted person to person via mucous membranes or through direct contact with a syphilis ulcer during vaginal, anal, or oral sex.

There are 4 main stages of syphilis: primary, secondary, latent, and tertiary. Active infection stages include primary, secondary, and early latency. Tertiary syphilis has a later onset in patients who never received initial treatment. Tertiary syphilis can include cardiac or neurologic manifestations known as neurosyphilis.

Ocular syphilis is a less common but a serious manifestation of T pallidum infection. All structures of the eye may be involved by syphilis, which is why it has been named the great imitator. Manifestations can include conjunctivitis, scleritis, episcleritis, keratitis, glaucoma, ocular motility disturbances, ptosis, pupillary changes, lens dislocation, uveitis, vitritis, chorioretinitis, or optic atrophy. Additionally, some ocular manifestations may occur years after initial involvement.

Ocular syphilis can be congenital or acquired. Congenital syphilis, despite its relative rarity, still poses a very significant threat to the eye. Acquired ocular syphilis can affect any individual; however, in the United States, it most commonly affects men. Individuals with the highest risk include men who have sex with men and those who are HIV-positive.

Related topics: primary syphilis, secondary syphilis, neurosyphilis, early and late congenital syphilis

Codes

ICD10CM:
A51.43 – Secondary syphilitic oculopathy

SNOMEDCT:
410478005 – Ocular syphilis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Syphilis is a great masquerader that can affect any part of the eye. Below are a few diagnoses that it can most commonly resemble:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:07/07/2020
Last Updated:07/28/2020
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Ocular syphilis - External and Internal Eye
Ocular syphilis : Eye pain, Blurred vision, Photophobia, Floaters, Conjunctival injection, Intravenous drug abuse, Sexually active
Clinical image of Ocular syphilis
Copyright © 2021 VisualDx®. All rights reserved.