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Ophthalmology and Visual Sciences

Interstitial Keratitis Secondary to Syphillis

Interstitial Keratitis Secondary to Syphillis

Category(ies): Cornea
Contributors: Lucas Lenci, MD; Prashant Parekh, MD, MBA
Photographer: Brice Critser, CRA

This is a 73-year-old male who presented initially for trabeculectomy surgery. Upon examination, the patient was found to have a corneal stromal scar with prominent ghost vessels. The patient was sent for blood work which returned positive for syphillis serologies.

He was referred to infectious diseases and treated. He was having no acute symptoms further suggesting this was a chronic process.

These lesions, when acute, present with neovascularization of the stroma, which some refer to as a salmon patch. Patients are also generally symptomatic initially with symptoms of photophbia, redness, and pain. Over time there is regression of these vessels leaving the images as seen above as a classic example of interstitial keratitis. The differential diagnoses is quite broad, but in the US the most common etiologies are HSV and syphillis.