Abstract

A 56 year old presented with bilateral poor vision of  6/36 . Fundus showed the presence of  perivasular sheathing along with multiple distinct retinal miliary lesions. Autofluroscence confirmed hypofluroscent lesions along the vascular arcades and at the posterior pole. She was positive for syphilis(1:1280dil) but  was HIV negative. Post consultation with a specialist, she was administered Benzathine penicillin(BP) along with posterior sub tenons Triamcinolone Acetonide with stable pressures of 13mmhg. Due to intolerance to oral steroids and failed compliance to BP, it triggered a relapse of disease. After persistence, completion of  BP course resulted in  reduction of serological titres to (1:320dil). Vision improved to 6/18 with healed vasculitis. This case is set forth due to the unusual presentation of latent ocular syphilis in an immunocompetent patient also to identify re-emergence and establish the need to rule out other diseases as syphilis is a great masquerader.

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