Acute corneal hydrops secondary to acquired syphilis

PurposeTo report a rare case of acute corneal hydrops and conjunctival ulceration secondary to acquired syphilis.MethodsA male in his late 30's presented with redness, pain, and watering in both eyes and sudden loss of vision in the left eye. Examination revealed bilateral conjunctival ulcers along with well-circumscribed corneal edema with blunt stunted intrinsic vessel in the left eye. Anterior-Segment Optical Coherence Tomography revealed immense corneal edema with stunted vessels suggestive of acute hydrops.ResultsTopical moxifloxacin with oral doxycycline was administered along with oral acetazolamide. The patient's serology (VDRL) was positive with Treponema Pallidum Hemagglutination Assay positivity. Intramuscular benzathine penicillin injections (weekly; 3 injections) were given and subsequently, there was complete resolution with corneal scarring and restoration of vision to 20/60 in the left eye.ConclusionThis is the first case to illustrate acute hydrops as a presenting sign of ocular syphilis.