Bilateral Optic Perineuritis Secondary to Neurosyphilis

Syphilis is an infection caused by the spirochete Treponema pallidum. A recent resurgence has been observed in many regions of the world including North America, especially in HIV patients. Ocular manifestations include interstitial keratitis, uveitis, chorioretinitis and optic neuropathy. Optic neuritis, papillitis and optic perineuritis have interchangeably been used in patients with syphilis and involvement of the optic nerve. We describe a case of patient with HIV and syphilis who presented with meningeal involvement causing optic nerve swelling bilaterally.