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Updated: May 22, 2026

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
12:23

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Published on: April 14, 2014

Neurosyphilis presenting as asymptomatic optic perineuritis.

Sarah E Parker1, John H Pula

  • 1Neuro-ophthalmology Unit, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Avenue, Peoria, IL 61611, USA.

Case Reports in Ophthalmological Medicine
|May 19, 2012
PubMed
Summary

Ocular syphilis, specifically optic perineuritis, can present as disc edema in asymptomatic individuals. Early diagnosis and treatment are crucial for central nervous system (CNS) syphilis to prevent disease progression.

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Published on: August 21, 2017

Area of Science:

  • Ophthalmology
  • Neurology
  • Infectious Diseases

Background:

  • Syphilis, a sexually transmitted infection, is recognized for its diverse clinical manifestations, including ocular complications.
  • Recent years have seen a rise in syphilis rates in the U.S., particularly among individuals with HIV.
  • Ocular involvement can be an early indicator of neurosyphilis.

Observation:

  • A case study of a 41-year-old male presenting with bilateral disc edema during a routine examination.
  • Cerebrospinal fluid analysis revealed an elevated white blood cell count, while brain MRI was normal.
  • Orbit MRI demonstrated optic nerve sheath expansion and enhancement, indicative of optic perineuritis.

Findings:

  • The patient was diagnosed with secondary syphilis based on positive serum RPR and FTA-ABS tests.
  • The clinical presentation of optic perineuritis was attributed to central nervous system (CNS) syphilis.
  • Disc edema was the primary ophthalmologic finding in this asymptomatic patient.

Implications:

  • Ophthalmologic signs, such as disc edema, can be the initial manifestation of CNS syphilis.
  • Optic perineuritis should be considered in the differential diagnosis of unexplained disc edema, even in asymptomatic patients.
  • Prompt diagnosis and treatment of CNS syphilis are essential due to the potential for irreversible neurological damage.