A recent medical mystery in southwest Michigan involving five women seeking help for serious eye problems led to a startling diagnosis: all of the patients had ocular syphilis, a complication of the sexually transmitted disease. The common link between the cases was that the women had all been with the same man, who had syphilis but never experienced eye-related symptoms. Ocular syphilis can lead to blindness if left untreated, and many patients are surprised to learn that syphilis can affect their eyes.
The prevalence of syphilis cases in the U.S. has been on the rise, with over 207,000 Americans diagnosed in 2020 – an 80% increase since 2018. The U.S. Department of Health and Human Services has referred to this as a “syphilis crisis” and an “epidemic.” Possible reasons for the rise include an increase in substance use leading to riskier sexual behavior, a decrease in condom use, and cuts in funding for STD testing clinics. As a result, more people are being hospitalized for syphilitic uveitis, the most common ocular manifestation of syphilis.
Syphilis is caused by a bacterium that can invade blood vessels and involve the central nervous system, making it possible for the infection to reach the brain and eyes. The disease can remain hidden in the body for a long time before causing symptoms, leading to delayed diagnosis and treatment. Ocular syphilis presents with symptoms such as red, light-sensitive, or painful eyes, as well as floaters, blurry vision, or blindness. It is essential to diagnose ocular syphilis early to prevent permanent damage to the eyes.
Treatment for ocular syphilis typically involves intravenous antibiotics for 10 to 14 days, along with anti-inflammatory medication to address eye inflammation. Early detection and treatment can yield positive outcomes for patients, but the challenge lies in the delayed diagnosis of the disease. Eye doctors are urged to have a high index of suspicion for syphilis when patients present with eye inflammation. Condom use during sex and regular vision exams can reduce the risk of contracting syphilis or other sexually transmitted diseases that can affect the eyes, such as herpes and gonorrhea.
In conclusion, the increasing prevalence of syphilis in the U.S. is leading to more cases of ocular syphilis, a potentially blinding complication of the disease. Awareness of the symptoms of ocular syphilis, such as eye inflammation, floaters, and blurry vision, is essential for early detection and treatment. Proper diagnosis and timely treatment with antibiotics and anti-inflammatory medication can lead to positive outcomes for patients. Eye doctors should maintain a high index of suspicion for syphilis when patients present with eye inflammation, and individuals should prioritize safe sex practices and regular vision check-ups to prevent the spread of STDs and protect their eye health.
