The great imitator on the rise: ocular and optic nerve manifestations in patients with newly diagnosed syphilis.

Ocular syphilis was found in one-quarter of the patients diagnosed with systemic syphilis and preceded the diagnosis of systemic disease in one-half of them. Optic nerve involvement was a common manifestation. A high index of suspicion for Treponema infection is required in patients presenting with optic nerve involvement to facilitate prompt diagnosis and treatment. Post-treatment visual outcome was good.