A cluster of five women in southwest Michigan sought help for severe eye issues within a short period, leading to a diagnosis of ocular syphilis, a complication of the sexually transmitted disease. All of the patients had sex with the same man who had syphilis but showed no symptoms affecting his eyes. Many people are surprised to learn that syphilis can endanger vision, and untreated syphilis in the eye can lead to blindness, according to Dr. Rahul Khurana, a spokesperson for the American Academy of Ophthalmology.
The increasing number of syphilis cases in the United States is alarming, with over 207,000 Americans diagnosed in 2022, an 80% increase since 2018 and the highest levels since the 1950s. Reasons for the surge in cases include a rise in substance use linked to risky sexual behavior, decreased condom use, and less funding for STD testing clinics. As a result, more people are being hospitalized for syphilitic uveitis, the most common ocular manifestation of syphilis, according to a publication in JAMA Ophthalmology in November 2023.
Syphilis is a sexually transmitted disease caused by a bacterium that invades blood vessels and can affect the eyes and brain. The illness can remain hidden in the body, causing symptoms later. Ocular syphilis presents non-specific symptoms that can mimic other conditions, making it easy to miss. Besides affecting vision, untreated syphilis can cause harm to the heart, brain, and lead to deafness and paralysis. Symptoms of ocular syphilis include red eyes, light sensitivity, pain, blurry vision, and floaters.
Early diagnosis and treatment are crucial for patients with ocular syphilis. Patients should see an infectious disease doctor for treatment, which typically involves an intravenous antibiotic for 10 to 14 days. Anti-inflammatory medication may also be prescribed to address eye inflammation. Treatment is most effective when started early, but the challenge lies in the delayed diagnosis of syphilis due to its non-specific symptoms. Condom use during sexual activity can reduce the risk of syphilis, and it is essential to get regular vision check-ups to rule out eye syphilis or other STDs that can harm the eyes, such as herpes and gonorrhea.
Overall, the increasing incidence of syphilis and STDs in the community underscores the importance of awareness and prevention. Patients should seek medical attention if they experience any vision problems, and eye doctors should have a high suspicion for syphilis when diagnosing eye inflammation. While early treatment can lead to positive outcomes, it may not undo any damage caused by the infection. By staying informed, taking preventive measures, and seeking timely medical care, individuals can reduce the risk of ocular syphilis and other eye-related complications associated with sexually transmitted diseases.
