The Great Imitator: Syphilitic Uveitis

Abstract

Syphilis is an important etiology of uveitis because of its curable nature. The prevalence of syphilis is increasing in developed countries especially among young males. Special consideration to its coexistence with the Human immunodeficiency virus (HIV) should be given. Since ocular syphilis can mimic most of the types of uveitis, it should be considered in the differential diagnosis of all types of uveitis. Syphilis causes posterior uveitis and panuveitis more frequently and its main clinical findings are focal preretinal white opacities and acute posterior placoid uveitis. Although imaging methods are utilized in the diagnosis, serological tests performed after clinical suspicion should be the main diagnostic approach. Knowing the pearls of the nontreponemal and treponemal serological tests is very important. All cases with ocular syphilis should be treated like neurosyphilis. Cerebrospinal fluid sampling should be performed in all ocular syphilis patients and all patients should be screened for HIV infection.