ABSTRACT
We present our findings in 14 patients with a serologically verified diagnosis of ocular syphilis. Although most patients had iridocyclitis, other ocular findings included episcleritis, scleritis, vitritis, retinitis, papillitis, panuveitis, cystoid macular edema, and retinal detachment. Most patients had only ocular manifestations of syphilis with no other definitive symptoms. Without the use of specific treponemal serologic tests, the diagnosis of ocular syphilis would have been missed in at least 20% of patients. Furthermore, 80% of patients were negative for antibody to syphilis in the cerebrospinal fluid, and therefore, this test should not be used to determine treatment for ocular syphilis. Currently, the most effective therapy for ocular syphilis is the same as that for neurosyphilis (i.e., high-dose intravenous penicillin G 12 to 24 million units/day for ten to 14 days). Human immunodeficiency virus-positive patients should receive a full 14 days of high-dose intravenous penicillin G plus intramuscular benzathine penicillin 2.4 million units weekly for three weeks because their immune defenses are likely to be impaired.
Subject(s)
Eye Infections, Bacterial/diagnosis , Penicillin G Benzathine/therapeutic use , Penicillin G/therapeutic use , Syphilis/diagnosis , Adult , Aged , Eye Infections, Bacterial/cerebrospinal fluid , Eye Infections, Bacterial/drug therapy , Female , HIV Infections/diagnosis , HIV Seropositivity/diagnosis , Humans , Injections, Intramuscular , Injections, Intravenous , Male , Middle Aged , Syphilis/cerebrospinal fluid , Syphilis/drug therapy , Syphilis Serodiagnosis , Treatment OutcomeABSTRACT
We reviewed the charts of 39 patients (45 eyes) with uveitis who underwent cataract extraction (intracapsular or extracapsular) with or without implantation of a posterior chamber intraocular lens (IOL) at the Royal Victoria Hospital, Montreal, between 1981 and 1990. The nine eyes with Fuchs' iridocyclitis in which an IOL was implanted had good visual results and few postoperative complications. The 18 eyes with uveitis other than Fuchs' iridocyclitis that received an IOL did not show a greater risk of postoperative complications than those left aphakic (n = 17), and the postoperative visual acuity was comparable to that of the aphakic eyes. Although the numbers are small, we conclude that the presence of uveitis does not automatically exclude posterior chamber pseudophakia.
