Ocular syphilis has been uncommon but is being encountered during recent outbreaks of syphilis, often in urban areas.
Criteria for ocular syphilis:
(1) signs and symptoms of ocular disease – vision loss, flashing lights, blurry vision, etc which may be manifestations of iritis, uveitis, or optic neuritis
(2) serologic evidence of syphilis
Late manifestations include the Argyll-Robertson pupil.
A patient with ocular syphilis should be:
(1) tested for HIV
(2) tested for evidence of neurosyphilis including hearing loss, neurologic signs and CSF changes
(3) the patient should be tested for other sexually-transmitted diseases
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