Syphilis masquerading as presumed tuberculosis retinal vasculitis

We report a case of a 44-year-old male with bilateral occlusive retinal vasculitis involving both arteries and veins, which was initially misdiagnosed and treated as presumed tubercular vasculitis. Subsequent testing for syphilis serology, based on clinical suspicion, revealed syphilitic retinal vasculitis. This case highlights the importance of considering syphilis as a differential for any type of retinal vasculitis, and clinical suspicion should guide further serology testing, rather than evaluating when the disease does not respond as the definitive treatment.