UNILATERAL SYPHILITIC PERIOPTIC NEURITIS

Perioptic neuritis is a rare ophthalmic manifestation of secondary syphilis in the HIV-infected patient; presentation is usually with bilateral disease. Basta et al describe an HIV-infected man with a short history of visual disturbance in the right eye, orogenital ulcers and rash. Ophthalmological examination showed reduced visual acuity and a swollen optic disc. Dark ground microscopy was negative for spirochetes, but blood and cerebrospinal fluid serology indicated secondary syphilis. The authors suggest that HIV-infected patients with secondary syphilis should be specifically questioned about visual symptoms and that syphilis should be considered in the differential diagnosis of patients presenting with optic …