# Optic Neuritis As the Initial Presentation of Syphilis

## TL;DR

A 41-year-old woman presented with optic neuritis as the first sign of syphilis and recovered after treatment.

## Contribution

This case highlights optic neuritis as a rare initial manifestation of ocular syphilis.

## Key findings

- Optic neuritis was the initial presentation of ocular syphilis in a previously healthy patient.
- Diagnosis was confirmed through nontreponemal and treponemal tests after ruling out other causes.
- The patient fully recovered after treatment with ceftriaxone.

## Abstract

Syphilis is transmitted via sexual contact and spreads through the lymphatic and hematologic systems. Ocular syphilis is an uncommon yet serious manifestation of syphilis that can cause significant vision impairment. This report presents a case of ocular syphilis in a 41-year-old otherwise healthy woman who presented with left-sided blurry vision and ocular discomfort. Examination confirmed decreased visual acuity and optic disc swelling in the left eye. Magnetic resonance imaging findings suggested optic neuritis. After ruling out other causes of optic neuritis and considering the presentation and diagnostic tests, including nontreponemal and treponemal, the diagnosis of ocular syphilis was confirmed. The patient was started on ceftriaxone and fully recovered.