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Atypical presentation of scleromalacia

Poster Details

First Author: F.March de Ribot SPAIN

Co Author(s):    P. Lopez Lizarraga   A. March de Ribot   R. Bolanos Jimenez              

Abstract Details


To report the evolution of a patient with anterior necrotizing scleritis in whom the diagnosis of syphilis was confirmed.




A 33 year old patient presented referring bilateral vision of both eyes of 2 weeks of evolution. Her visual acuity on the right and left eye was 20/200 and 3/200 respectively. Her positive signs on physical examination of both eyes there was an important scleral thinning 360 degrees with narrowing of the diameter of the cornea due to sclerocornea. The zonule had important instability in the upper quadrants with nucleus subluxation. On the left eye it was possible to see vitreous bands emerging into the anterior chamber and touching the corneal endothelium.


Laboratory studies revealed positive VDRL and antireponema antibodies. The patient was treated with benzatinic penicillin, 2.4 million of Units every week for three doses, and cycloplegics. Due to the fact that her visual acuity improved significantly to 20/60 on both eyes, it was decided to leave her under observation.


Ocular syphilis has various forms of presentation. It forms part of the great simulators. In atypical uveitic cases its possible role must always be taken into account. A prompt diagnosis and adequate treatment improves the patients’ prognosis.

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