Syphilis is a systemic infectious disease known as the “Great Masquerader” for its ability to mimic a wide range of ocular conditions, potentially involving any ocular structure. We report the case of a 26-year-old man with a history of unprotected sexual intercourse who presented with a two-week history of a painful, red right eye without loss of visual acuity. Examination revealed nodular lesions on the temporal sclera and concomitant reddish-brown palmar spots. Laboratory tests were performed to determine the etiology of the anterior nodular scleritis. Serologic testing (treponema pallidum hemagglutination assay (TPHA)/Venereal Disease Research Laboratory test (VDRL)) was positive, confirming syphilitic nodular scleritis. The patient showed rapid clinical improvement following penicillin therapy.
Benchekroun et al. (2026) studied this question.