Great imitator — ocular syphilis

We examined a 44-year-old woman without any known systemic disease with decreased vision of month duration in her left eye. She had undergone uneventful cataract surgery intraocular lens implantation elsewhere 14 years ago. On examination, Snellen visual acuity was 1.0 (with the correction –0.50–0.25 × 120) right eye and 0.4 +0.75–2.25 115) left. There hypochromic heterochromia. While anterior segment unremarkable, there were small to medium-sized keratic precipitates, 3+ chamber cells, posterior an intact capsule, few vitreous cells Fundus autofluorescence imaging revealed peripapillary hyperautofluorescence eye, fluorescein angiography marked optic nerve head perivascular leakage at pole. The findings not compatible Fuchs uveitis, so full infectious panel worked out. Serologic investigations yielded presence syphilis, patient treated successfully antibiotics. Our case demonstrates mimicking nature ocular syphilis importance high clinical suspicion when reaching correct diagnosis.