Abstract

A 40-year-old male presented with a complaint of defective vision in left eye (LE)for the past month. BCVA in both eyes (BE) was 6/6. Posterior segment examination of the LE revealed anterior vitreous (AVF) cells at 2+ & whitening in the posterior pole, as depicted in Fundus Photo and Blue Autofluorescence (BAF) and LE OCT showed PR (Photoreceptor) layer discontinuity. After ruling out infections such as TB, HIV, and syphilis, the patient was initiated on oral steroids. After 15 days, the patient returned with defective vision in his right eye (RE), and a new onset of a white lesion in the posterior pole of the RE, along with clinical deterioration in the LE and multiple placoid lesions in BE. Upon retesting, TPHA showed a strongly positive result & case diagnosed as LE Ocular Syphilis. Oral steroids have stopped & patient was commenced on oral doxycycline & intravenous benzathine penicillin. After 1 month, the lesions began to regress & after 3months, they had completely resolved.