AIM: To report a rare case of optic perineuritis secondary to syphilis infection with severe visual loss showing a dramatic improvement following treatment with corticosteroids.METHODS: Case report.RESULTS: A 66-year-old Malay lady presented to us with sudden onset of unilateral loss of vision and pain on eye movement. Her vision had no perception of light and marked relative afferent pupillary defect (RAPD) was present over the right eye. Serological and radiological investigation showed evidence of syphilitic optic perineuritis. She was treated with intramuscular benzathine penicillin and intravenous methyl prednisolone, followed by oral steroid with tapering dose for long period. Her visual acuity improved remarkably after the treatment. She regained the vision of 6/18 and there was no sign of recurrence or steroid related side effects during 4 months follow-up.CONCLUSION: Accurate diagnosis and prompt treatment of this case has converted a poor vision to a better visual outcome.

·Acquired uniocular blindness in pediatric group deserves an urgent attention. The blindness usually results from mechanical injury to the globe. It is one of the leading causes of acquired blindness in this group. Most of the ocular injuries were accidental and resulted from mechanical trauma. Firecracker is one of the potential causes for acquired uniocular blindness. The nature of injury varies from mild to severe, penetrating or blunt trauma, chemical or thermal. The irreversible nature of the visual loss is preventable. Public awareness will be one of the main contributors in preventing the ocular morbidity.