Man diagnosed with rare case of syphilis in both eyes

Close up of an eye
(Photo: Posed by model, via Unsplash)

A 39-year-old man in Australia has been diagnosed as having syphilis in both his eyes. The case was reported in the journal BMJ Case Reports.

Although syphilis can infect any part of the body, it’s previously been noted in one eye at a time. This is only the second time anyone who is not HIV-positive has been diagnosed with the infection in both their eyes.

Related: Syphilis: What is it and why should gay men get tested regularly? 

The unnamed man, who is in a same-sex, open relationship, sought medical advice after experiencing headaches for three weeks. He told docs the pain was noticeable when he moved his eyes. However, his vision remained unchanged.

An examination revealed that swelling in both optic nerves. Further tests revealed he was infected with syphilis.

It’s believed the primary site of infection was his genitals. Untreated, the infection had spread to other parts of his body, including his nervous system.

There has been a marked increase in the incidence of syphilis in the US, Canada, UK, and Australia in recent years. Gay and bisexual men are among those showing a rising rate of infection.

In the US, cases increased by 14.4 percent between 2017 and 2018, with 64 percent among men who have sex with men.

Some believe this is due to more men having sex without condoms. That said, not even condoms will always protect you.

Related: Coming Soon: Syphilis in your eyes. So watch out. (Pun intended.)

Often, the symptoms of syphilis can be overlooked, so people don’t know they have it until it begins to spread, sometimes years later.

It’s one of the reasons all sexually-active gay men are encouraged to have a regular sexual health check-up – at least once a year. If they are taking PrEP or have multiple sexual partners, having a full sexual health check-up every 3-6 months is recommended.

In this instance, the man said he had unprotected sex with several partners, besides his primary relationship.

Fortunately, syphilis responds well to treatment, and the earlier it’s detected, the better. In this case, the man was put on an antibiotic drip for two weeks and the infection was treated. If caught sooner, an injection of antibiotics would probably have sufficed. His vision was not affected, although some swelling remained in one optic nerve. Left untreated, he could have lost sight in both eyes.