Page 18 - Jan-Feb 2025

BLURRED VISION ASSOCIATED accommodation facility,
saccadic eye movement, speed
WITH OCULAR SYPHILIS of recognition, peripheral
awareness, and hand-eye
coordination, all of which showed
A report published in BMJ Case Reports describes the significant changes (P < 0.05),
treatment of a man in his 50s who had a three-week history of while visual memory remained
painless blurred vision. The vision was worse in his right eye as unaffected (P = 0.556).
compared to his left eye.
The study involved 80
The man was treated by US clinicians in a Michigan inactive female participants,
hospital. When probed about his social history the patient randomly assigned to an
revealed having unprotected sex with multiple female and experimental or control group.
male partners in the past. His best corrected visual acuity was None had engaged in regular
20/350 in his right eye and 20/30 in his left eye. physical activity for six months.
According to the authors of the report, the US clinicians Participants underwent an
found bilateral papilloedema when they did a dilated fundal optometric evaluation using
examination while the CT scan of the brain revealed a 5mm Spectrum Eyecare software
left subdural haematoma. After blood tests and a sexually to confirm 20/20 vision. Tests
transmitted infections workup, ophthalmology and infectious assessed kinanthropometry,
disease specialists mutually determined that the presentation hand-eye coordination, and
was consistent with ocular syphilis. peripheral awareness after
The patient was given penicillin treatment, however, he fasting for 9 to 12 hours.
developed a Jarisch-Herxheimer reaction. He developed a The experimental group
fever, rash and worsening headaches due to the enlargement performed an incremental
of subdural haematoma – he had to undergo a burr hole maximal treadmill exercise,
drainage for this. increasing speed and incline until
The 14-day course of penicillin treatment did improve his reaching termination criteria. The
vision but the issue did not completely resolve. Due to this, the control group did not exercise.
authors summed up that syphilisis is a “great imitator” that All participants were reassessed
can present in many different forms with symptoms that are after a two-week washout period.
initially vague. Findings suggest that acute
exercise can enhance or impair
“Ocular syphilis should be suspected in any patient with visual performance, complicating
known syphilis or risk factors for syphilis such as men who concussion assessments
have sex with men, advanced age, people living with HIV, drug conducted immediately after
use, and reinfection after a previous infection,” the authors head trauma.
concluded.
The authors stress the
importance of including
STUDY ON EXERCISE- visual tests in SRC protocols,
as concussions frequently
INDUCED CHANGES IN VISUAL affect visual pathways. Medical

PERFORMANCE professionals are encouraged
to account for exercise-induced
fluctuations in visual function to
A recent study published in the Journal of Optometry found improve return-to-play decisions.
that intense aerobic exercise significantly affects visual performance, Further research is needed
raising concerns about the reliability of sideline sports-related to explore variations across
concussion (SRC) assessments. Researchers led by Dr. Brandon different sports, play levels, and
S. Shaw examined how maximal aerobic exercise influences male athletes.

14 ̶ THE INDIAN OPTICIAN | JAN-FEB 2025 | OPTOMETRY NEWS