Syphilis: an ancient foe with multiple faces.

Syphilis can have a multitude of different ophthalmological presentations. The authors present a case of a 59-year-old man, with complaints of bilateral blurred vision starting 6 months before. His best-corrected visual acuity was 20/20 in both eyes. Ophthalmological examination revealed bilateral superotemporal retinal oedema, extending to the superior macular region, with a white stippled discolouration of the corresponding retinal pigment epithelium. Laboratory work-up confirmed the diagnosis of syphilis. The patient was treated with penicillin G benzathine-2.4 million IU intramuscular weekly for 3 weeks. After treatment, a clinical improvement of the fundus lesions was observed along with a subjective improvement in visual function. Over a 12 month follow-up period, no recurrences have occurred.