My eye doctor can detect which disease? - Syphilis

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "My eye doctor can detect which disease?". Some might surprise you, some might not. In light of the recent announcement of a huge spike in this disease in Alberta, I thought I would cover syphilis.

Yes. Syphilis.

“Over the past four years, the rate of reported syphilis infections has increased ten fold!”

While syphilis is a sexually transmitted infection it can show up in the eye much like most other STIs. While some symptoms occur in more obvious areas, as your eye doctor I’m not going to be examining anything beyond your eyes.

So why talk about this disease in particular? Over the past four years, the rate of reported syphilis infections has increased ten fold! Yikes! Syphilis is also tricky to diagnose. It can present in a lot of different ways and routinely becomes latent, hiding out in your body with no symptoms whatsoever!

What is your optomtrist looking for then, when considering the possibility of syphilis? A sore, called a chancre, can sometime occur on the eyelid or the white of the eye. It’s a painless ulcer that resolves on its own but is a pretty good indication that someone might have syphilis and requires testing.

These cute little spirals are syphilis and they are not your friend

These cute little spirals are syphilis and they are not your friend

If left undiagnosed, syphilis progresses to what we call secondary syphilis. Once we get to this stage we can see signs of inflammation in the eye like uveitis or optic neuritis, painful inflammations that can cause vision loss (either temporary or permanent). Less commonly, it can present as an eye infection or more benign inflammation with the eye simply appearing red.

If it goes on way too long we can move into tertiary syphilis which can start to impact you central nervous system and cause other nasty symptoms including the atrophy (a fancy word for loss of function) of your optic nerve or pupils that don’t respond properly to light.

Nobody wants syphilis, obviously, but if you think you might have it definitely talk to your family physician or your local STI clinic and get tested. Not knowing also risks spreading the infection and we know you don’t want to do that!

The good news is that syphilis can be treated with medication but typically requires the medication be injected. So even if you can treat syphilis it's always better to just not get it in the first place. You'll save yourself from an embarrassing discussion with your partner(s) if you protect yourself.

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