Tunnel Vision in a Case of Neurosyphilis with Inflammatory Cerebrospinal Fluid

Abstract

Tunnel vision is essentially a limitation of lateral vision, also known as peripheral vision loss. The main etiology is glaucoma, but it can also be present in retinitis pigmentosa, retinopathy associated with diabetes mellitus, retinal detachment, optic neuritis, central retinal vein occlusion, migraine, stroke, or concussion. We present the case of a young adult with a history of risky sexual contacts who developed initial tunnel vision, with bilateral optic disc edema, related to neurosyphilis treated with penicillin G and resolved without any visual sequelae. This clinical case describes an atypical initial manifestation related to neurosyphilis. With this clinical case, we aim to highlight that when faced with the symptoms of tunnel vision, an ocular pathology should be ruled out first, but a neurological evaluation is also essential to rule out other etiologies.