Keratopathy from Congenital Syphilis

PURPOSE.Therapeutic decision-making in syphilitic corneal disease is discussed after seeing a patient with keratopathy from congenital syphilis. METHODS.Case report and review of the literature. RESULTS.Laboratory evaluation of our patient revealed a nonreactive serum rapid plasma reagin (RPR) test and a positive microhemagglutination assay—Treponema pallidum (MHA-TP) test. CONCLUSION.Any patient with residual interstitial keratopathy, especially if bilateral, should be suspected to have congenital syphilis if the patient or parents were ever treated for a sexually transmitted disease, if stigmata of congenital syphilis are present, or if childhood ocular inflammation occurred.