Current ophthalmology practice patterns for syphilitic uveitis

Genevieve Oliver, Roy Stathis, Joao Fortes Furtado, Tiago Arantes, Peter McCluskey, Janet M. Matthews, International Ocular Syphilis Study Group, Justine Smith

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)
33 Downloads (Pure)


Background: Syphilitic uveitis is re-emerging alongside the systemic infection. In July 2017, an international group of uveitis-specialised ophthalmologists formed the International Ocular Syphilis Study Group to define current practice patterns.

Methods: 103 Study Group members based in 35 countries completed a 25-item questionnaire focused on case load, clinical presentations, use and interpretation of investigations, treatment and clinical indicators of poor prognosis.

Results: Members managed a mean of 6.1 patients with syphilitic uveitis in clinics that averaged 707 annual cases of uveitis (0.9%); 53.2% reported increasing numbers over the past decade. Patients presented to more members (40.2%) during secondary syphilis. Uveitis was usually posterior (60.8%) or pan (22.5%); complications included optic neuropathy, macular oedema and posterior synechiae. All members diagnosed syphilitic uveitis using serological tests (simultaneous or sequential testing algorithms), and 97.0% routinely checked for HIV co-infection. Cerebrospinal fluid (CSF) analysis was ordered by 90.2% of members, and 92.7% took uveitis plus Venereal Disease Research Laboratory test (VDRL) or fluorescent treponemal antibody absorption test (FTA-ABS) to indicate neurosyphilis. Patients were commonly co-managed with infectious disease physicians, and treated with penicillin for at least 10–14 days, plus corticosteroid. Features predicting poor outcome included optic neuropathy (86.3%) and initial misdiagnosis (63.7%). Reasons for delayed diagnosis were often practitioner-related. 82.5% of members tested every patient they managed with uveitis for syphilis.

Conclusion: This comprehensive report by an international group of uveitis-specialised ophthalmologists provides a current approach for the management of syphilitic uveitis.
Original languageEnglish
Pages (from-to)1645-1649
Number of pages5
JournalBritish Journal of Ophthalmology
Issue number11
Publication statusPublished - 1 Nov 2019

Bibliographical note

Accepted author manuscript published according to the publisher's Institutional Repository Policy.


  • Ophthamology
  • Syphilitic Uveitis
  • infection
  • inflammation
  • eye, syphilis, uveitis


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