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Use of intravitreal dexamethasone implant to control paradoxical worsening in a case of syphilitic acute placoid posterior chorioretinitis

Paradoxical worsening of ocular syphilis after initiation of antimicrobial therapy is rare, however it is important for the clinicians to be aware of this occurrence, as prompt recognition and timely intervention with corticosteroids can lead to restoration of vision. Alteration/discontinuation of antimicrobial therapy may not be indicated. Our case highlighted the role of dexamethasone implant to control such paradoxical worsening in a young patient with ocular syphilis.