Syphilitic episcleritis and scleritis.

We screened patients with episcleritis or scleritis to detect syphilis by using either fluorescent treponemal antibody absorption testing or microhemagglutination assay for antibodies to Treponema pallidum. Four patients, two with nodular episcleritis and two with scleritis, had ocular involvement as the initial manifestation of late syphilis. Topical or oral corticosteroid therapy provided minimal initial clinical benefit, but ocular inflammation resolved within one to three weeks after administration of systemic penicillin.