Nodular syphilitic scleritis: a rare and forgotten entity.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Syphilology

Background:

• Syphilis, a systemic infection, can present with diverse ocular manifestations.
• Ocular syphilis typically occurs in secondary or tertiary stages, often as a nonspecific inflammatory response.

Observation:

• A patient presented with unilateral nodular scleritis.
• The patient was diagnosed with late latent syphilis.

Findings:

• The nodular scleritis resolved following a 2-week course of intravenous crystalline penicillin.
• Topical fluorometholone and tobramycin eye drops administered for 3 weeks further supported the resolution.

Implications:

• This case underscores the importance of considering syphilis in the differential diagnosis of scleritis, even in late latent stages.
• Early and appropriate treatment of ocular syphilis can prevent vision-threatening complications.