A young woman with a gradual onset of blurred vision was found to have a bitemporal hemianopia. It was possible that these symptoms represented an early optochiasmatic arachnoiditis. Inflammatory eye changes with bilateral neuroretinitis and anterior uveitis were then noted. A protracted course of exacerbations and remissions occurred during a one-year course of systemic steroid therapy. After a reactive fluorescent treponemal antibody absorption test was found, spirochetes were demonstrated in the aqueous humor. The patient was then given more than nine million units of long-acting penicillin. One month later, at a second paracentesis, spirochetes were again found. These organisms were motile on darkfield examination, and stained with fluorescein tagged anti-Treponema pallidum globulin.
Smith JL, Israel CW. Spirochetes in the Aqueous Humor in Seronegative Ocular SyphilisPersistence After Penicillin Therapy. Arch Ophthalmol. 1967;77(4):474-477. doi:10.1001/archopht.1967.00980020476009