April 20, 2018 Conference


Making a Comeback: Syphilis on the Rise

Dr. Lana Rifkin, Ophthalmic Consultants of Boston (Presenter)

Syphilis, an ancient disease, first noted in the 1400’s, has unfortunately been making a comeback all across the world, with reports of increased activity in every nation.  Rates in 2015 were the highest on record, with the CDC reporting nearly an 18% rise in documented cases of syphilis. Reasons for this alarming statistic vary from unprotected sexual activity, particularly in men having sex with men to new HIV-preventing medications which decrease the stigma associated with condom-free sex, to online dating apps.

Traditionally, practitioners have tested for syphilis with non-specific treponemal tests such as RPR and VDRL. However, these tests may give a false sense of security as they may not turn positive in acute disease. Specific treponemal tests such as Treponema pallidum antibody or fluorescent treponemal antibody absorbed (FTA-Abs) should be checked to avoid missing this important diagnosis.

The ocular presentation of syphilis can vary from scleritis to panuveitis and thus it is prudent to include testing for syphilis for those uveitis patients who warrant a systemic uveitis evaluation, regardless of age, gender, or reported risk factors.