Painless syphilitic uveitis in the Emergency Department.

INTRODUCTION Syphilis is a sexually transmitted, systemic, chronic infection that can affect all structures of the eye from cornea to optic nerve.1,2 The British Ocular Syphilis Study (BOSS) reported an annual incidence of intraocular syphilis of 0.3 per million UK adult population based on 2014 data. Bilateral ocular involvement was present in 56%, and the mean presenting Snellen visual acuity was 20/63. Pan-uveitis was diagnosed in 41.3% of cases, followed by isolated anterior uveitis (9.5%) as the next most common diagnosis.3 Epidemiological data suggests that ocular findings of syphilis occur in 2.5-5% of patients with tertiary syphilis and may be a presenting manifestation of syphilis.1,4 While 90% of syphilis cases occur in developing countries, an increasing trend of syphilis cases is present in young men in industrialized nations.5 While commonly regarded as a painful entity, an exact incidence of painless syphilitic uveitis remains unclear.