A Case Series of Ocular Syphilis Cases at Military Treatment Facility From 2020 to 2021

Syphilis is a sexually transmitted infection, caused by the spirochete Treponema pallidum, that can lead to multi-organ involvement. In 2020, over 138,000 cases were reported in the United States equating to a case report of 40.8 per 100,000 people. Ocular syphilis is a rare manifestation and is defined as the clinical presentation of ocular disease in a person with laboratory-confirmed syphilis infection of any stage, with estimated incidence of 0.6-2% of all cases. Syphilis is known as "The Great Imitator," and can present as nearly any form of ocular disease, though the most common manifestations are posterior uveitis and panuveitis. The highly variable clinical presentation of ocular syphilis often leads to delayed diagnosis allowing the potential for poor, often preventable outcomes. This highlights the need for providers to have a high level of clinical suspicion and awareness of ocular manifestations of syphilis, especially in high risk populations. We present a case series of five patients diagnosed with ocular syphilis at a military treatment facility. Each patient had different presenting symptoms as well as different ocular manifestations.