Syphilis is a chronic infection caused by Treponema pallidum. Iridocyclitis occurs in patients with secondary acquired syphilis. It is a bilateral disease in which the iris vessels are particularly engorged. Chorioretinitis can be either multifocal or diffuse and involves the mid periphery and peripapillary area. In the healed phase, perivascular bone spicule pigmentation could be seen similar to that observed in retinitis pigmentosa.
In congenital syphilis, other possible features occur such as deafness and corneal scarring from previous interstitial keratitis. The scattered pigmentation in the fundus might suggest an inherited retinal degeneration but a careful family history together with electrodiagnostic testing of the eyes usually enables one to distinguish the two conditions. It is also important to carry out serological testing. The T. pallidum immobilisation test and the fluorescent treponemal antibody test are the most sensitive and specific.
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