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October 28, 1939

CORNEAL EXAMINATION AND SLIT LAMP MICROSCOPY: IN DIAGNOSIS OF LATE CONGENITAL SYPHILIS, ESPECIALLY IN ADULTS

JAMA. 1939;113(18):1624-1627. doi:10.1001/jama.1939.02800430016004
Abstract

A cornea once involved with interstitial keratitis caused by congenital syphilis presents, almost without exception, certain sequelae which persist for the rest of the patient's life. Although the characteristic signs of an old interstitial keratitis can often be detected by oblique illumination and ophthalmoscopic examination, a proper study should and often can be performed only by biomicroscopy. With the corneal microscope and slit lamp a diagnosis of old interstitial keratitis can invariably be made, regardless of the age of the patient. We believe that the importance of slit lamp examination in clinical syphilology has not been sufficiently emphasized. The changes observed may be the only evidence of congenital syphilis. Their presence in adults and old patients may explain the absence of the history of infection, and they may serve as a means of interpreting positive or weakly positive results of Wassermann or precipitation tests. In the presence of other signs

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