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August 1996

Anterior Nodular Scleritis Secondary to Syphilis

Arch Ophthalmol. 1996;114(8):1015-1016. doi:10.1001/archopht.1996.01100140223022

Syphilis is a sexually transmitted disease that is commonly referred to as the "great imitator" because of its ability to mimic a variety of systemic and ocular diseases. This elusive characteristic of syphilis has often led to a delay in diagnosis or an incorrect diagnosis, particularly with respect to ocular manifestations. Ocular involvement in syphilis usually occurs in the secondary or tertiary stages of the disease; it is typically manifested as a nonspecific inflammatory response.1 A frequently overlooked ocular manifestation of syphilis is scleritis. When present in isolation, syphilitic scleritis often produces a diagnostic dilemma. We describe a patient with ocular syphilis who displayed the symptoms of isolated, anterior nodular scleritis when first seen.

Report of a Case.  We examined a 67-year-old woman at a community health fair; she complained of pain in her right eye, which she had experienced for several weeks. We referred her to the General

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