Key Points For Healthcare Providers
Did You Know That Lyme Disease Can Affect Your Eyes
May 16, 2022 By Johns Hopkins Lyme Disease Research Center
Lyme disease is a tick borne infectious disease caused by the bacterium, Borrelia burgdorferi . It is well known that Bb can disseminate from a tick bite throughout the body to the joints, heart, and nervous system. Less well known, is the impact that Lyme disease can have on the eyes.
Research at our Center has identified impairments in eye functioning and eye inflammation in patients with Lyme disease:
- Visual contrast sensitivity impairment occurs in post treatment Lyme disease patients and is linked to signs of cognitive and neurologic impairment and may be a marker of illness severity.
- Horner Syndrome with Negative Serology is an unusual presentation of Lyme disease.
- Lyme disease can also be an uncommon cause of Scleritis in endemic areas.
Potential eye or neuro-ophthalmologic symptoms that could be associated with Lyme disease include:
- Cranial nerve damage resulting in double vision
- Optic nerve inflammation
- being very sensitive to bright light
- having blurry vision
- seeing eye floaters
- redness and swelling of the white part of the eye
- blurred vision
What Is Neurologic Lyme Disease
Neurologic symptoms of Lyme disease occur when the Lyme disease bacteria affect the peripheral or central nervous systems.
- Cranial nerve involvement: When the cranial nerves are affected, facial palsy can occur on one or both sides of the face.
- Peripheral nerve involvement: When the peripheral nerves are affected, patients can develop radiculoneuropathy which can cause numbness, tingling, shooting pain, or weakness in the arms or legs.
- Central nervous system involvement: When the central nervous system is affected, Lyme meningitis can cause fever, headache, sensitivity to light, and stiff neck.
Out of every 100 patients whose cases are reported to CDC, 9 have facial palsy, 4 have radiculopathy, and 3 have meningitis or encephalitis. Because of reporting practices, this statistic may overestimate how often these manifestations are seen by clinicians.
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Lyme Disease And Vision
Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. In its early stages, Lyme disease commonly results in a rash, which can appear anywhere from one day to one month after a tick bite, joint pain and headaches. Later-stage Lyme disease is characterized by arthritic pain, cognitive difficulties, fatigue and other symptoms that can have an enormous effect on a patients life.
One tick may carry more than one disease, so sometimes people get more than one co-infection from the bite of a single tick. Experienced doctors may be able to distinguish each of the tick-borne co-infections and order appropriate tests and treatment.1 If left untreated, infection can spread to joints, the heart, and the nervous system.
The Centers for Disease Control estimates that more than 300,000 new cases of Lyme disease occur each year in the U.S. However, some experts suggest this number may be under-estimated.
Stage : Early Disseminated Lyme Disease
Early disseminated Lyme disease occurs several weeks to months after the tick bite.
Youll have a general feeling of being unwell, and a rash may appear in areas other than the tick bite.
This stage of the disease is primarily characterized by evidence of systemic infection, which means infection has spread throughout the body, including to other organs.
Symptoms can include:
- disturbances in heart rhythm, which can be caused by Lyme carditis
- neurologic conditions, such as numbness, tingling, facial and cranial nerve palsies, and meningitis
The symptoms of stages 1 and 2 can overlap.
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What Are Signs And Symptoms Of The Third Stage Of Lyme Disease
Late stage Lyme disease can result when treatment is unsuccessful or started too late due to unrecognized symptoms or misdiagnosis. The late disseminated stage occurs months or years after initial infection and can have a major impact on a patients health and quality of life. Late Lyme arthritis is a third stage Lyme disease manifestation that involves fluid accumulation and pain in joints, particularly in the knee joints. Late neurologic disease is a 3rd stage condition that can also be debilitating and difficult to diagnose. Late disseminated Lyme disease symptoms include a variety of symptoms that are often neurologic in origin including: numbness in extremities, mental fogginess and concentration problems, and difficulty following conversations or processing information.
Eye Problems Associated With Lyme Disease
- Details
Lyme disease is an infection that is caused by a spirochete called Borrelia burgdorferi. It is transmitted to humans by the bite of a deer tick.
The disease has a strong geographical incidence, being highly concentrated in the Northeast United States and now also has a high incidence in Minnesota and Wisconsin.
Lyme disease was first discovered in Old Lyme, Connecticut in 1975. It can start with a characteristic bulls eye rash, in which there is a central spot that is surrounded by clear skin that is then ringed by an expanding rash. It can also appear just as an expanding rash.
This rash usually starts within days of the tick bite. Eye problems can occur along with this rash in the first phase of the disease. This includes red eyes that can look like full-blown pink eye, along with eyelid swelling. It also can produce iritis or uveitis, which include sensitivity to light and inflammation inside the eye.
The second phase of the disease usually starts within a few weeks of the tick bite and this occurs because the spirochete gets into the blood stream. This stage often has rashes starting away from the original bite site. It can also produce joint pain, weakness, and inflammation in several organs including the heart, spleen, liver and kidneys.
The diagnosis is made through observation of the presenting symptoms, being in an area where there are significant numbers of the disease-carrying ticks, and a blood test that can confirm the diagnosis.
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Stage : Early Localized Disease
Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.
The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isnt painful and doesnt itch. This rash will gradually fade in most people.
The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people dont have this symptom.
Some people have a rash thats solid red, while people with dark complexions may have a rash that resembles a bruise.
The rash can occur with or without systemic viral or flu-like symptoms.
Other symptoms commonly seen in this stage of Lyme disease include:
Minimal Risk Of Getting Eye Problems
In case it is suspected that eye problems are caused by Lyme disease, the antibody tests dont give a decisive answer. This reason for this is that a positive antibody test can also indicate an infection that took place longer ago. However, when a doctor suspects that Lyme disease is the cause of eye problems, it can be treated with antibiotics that also reach the eye well. In the aforementioned magazine, for example, an effective treatment with ceftriaxon was prescribed.
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Lyme Disease And Your Eyes
Lyme disease is an infection that is caused by a spirochete called Borrelia burgdorferi. It is transmitted to humans by the bite of a deer tick.
The disease has a strong geographical incidence, being highly concentrated in the Northeast United States and now also has a high incidence in Minnesota and Wisconsin.
Lyme disease was first discovered in Old Lyme, Connecticut in 1975. It can start with a characteristic bulls eye rash, in which there is a central spot that is surrounded by clear skin that is then ringed by an expanding rash. It can also appear just as an expanding rash.
This rash usually starts within days of the tick bite. Eye problems can occur along with this rash in the first phase of the disease. This includes red eyes that can look like full-blown pink eye, along with eyelid swelling. It also can produce iritis or uveitis, which include sensitivity to light and inflammation inside the eye.
The second phase of the disease usually starts within a few weeks of the tick bite and this occurs because the spirochete gets into the blood stream. This stage often has rashes starting away from the original bite site. It can also produce joint pain, weakness, and inflammation in several organs including the heart, spleen, liver and kidneys.
The diagnosis is made by observing the presenting symptoms, being in an area where there are significant numbers of the disease-carrying ticks, and a blood test that can confirm the diagnosis.
Symptoms Of Lyme Disease
People with Lyme disease may react to it differently, and the symptoms can vary in severity.
Although Lyme disease is commonly divided into three stages early localized, early disseminated, and late disseminated symptoms can overlap. Some people will also present in a later stage of disease without having symptoms of earlier disease.
These are some of the more common symptoms of Lyme disease:
- a flat, circular rash that looks like a red oval or bulls-eye anywhere on your body
- other flu-like symptoms
These symptoms may occur soon after the infection, or months or years later.
Your child may have Lyme disease and not have the bulls-eye rash. According to an early study, results showed roughly 89 percent of children had a rash.
Lyme disease is best treated in the early stages. Treatment for early localized disease is a simple 10- to 14-day course of oral antibiotics to eliminate the infection.
Medications used to treat Lyme disease include:
- doxycycline, amoxicillin, or cefuroxime, which are first-line treatments in adults and children
- cefuroxime and amoxicillin, which are used to treat women who are nursing or breastfeeding
Intravenous antibiotics are used for some forms of Lyme disease, including those with cardiac or central nervous system involvement.
After improvement and to finish the course of treatment, healthcare providers will typically switch to an oral regimen. The complete course of treatment usually takes 1428 days.
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Can Lyme Disease Cause Vision Problems
Chronic Lyme patients experience a variety of localized symptoms, but vision trouble is something we get asked about a lot. Dr. Bill Rawls explains how Borrelia and Lyme coinfections can affect the eyes, plus he shares insights on what can help. Learn more about Lyme disease symptoms, tests, and treatment options here.
Ocular Signs Of Lyme Disease
Lyme disease is a tick-borne disease that can cause symptoms in many body systems, including the eyes, well after the initial tick bite occurs.Ocular problems are uncommon side effects of Lyme disease that can occur in the early or late phase of the disease and can take many different forms. Treating Lyme disease with antibiotics along with treating specific eye complications is essential to prevent recurrent eye problems.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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What Are The Most Common Symptoms Of Lyme Disease
Aside from the aforementioned symptoms, many people with Lyme disease may experience others such as fatigue, fever, headache, sort throat, and swollen glands. As the disease worsens, cognitive health, along with the health of various other organs and tissues, can become compromised. The area of the body affected depends entirely on where the bacteria has infiltrated.
Image by on Can Lyme disease cause blurred vision?
How Is Lyme Disease Diagnosed
Lyme disease can be difficult to diagnose because many patients are unaware of the tick bite or the rash . Another problem is that some of the nervous system signs and symptoms can mimic another disease, multiple sclerosis. When a physician suspects lyme disease, blood tests may help in the diagnosis. Unfortunately, none of the blood tests available are highly accurate. Because of the difficulties of diagnosis, some persons are misdiagnosed as having lyme disease, and in some other persons the diagnosis is suspected but never confirmed.
In addition to blood testing, another way to confirm an uncertain diagnosis is to test a patients response to a trial of therapy.
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The CDC estimates that more than 300,000 new cases of Lyme disease occur every year in the U.S. and that number is likely understated.
According to a recently released analysis from Quest Diagnostics, Lyme disease can be found in all 50 states and Washington, D.C.
Lyme disease is the best known of more than a dozen tickborne illnesses in which tiny bacteria called spirochetes are injected into the body with the tick saliva. If not treated, these spirochetes multiply and spread, eventually reaching the brain, where they can cause a range of neurological effects.
Lyme disease is difficult to diagnose, in part because it is a great mimicker of other conditions. Additionally, many people never realize theyve been bitten by a tick unless they see the bulls eye rash that is characteristic of Lyme. Blood tests for Lyme often produce a false negative result, because the spirochetes spend much of their time dormant in tissue, only prompting the immune system to produce detectable antibodies when they enter the bloodstream.
Visual system damage
Effective techniques
Three tips to help your patients
Recognize that Lyme disease could be the underlying cause of sudden-onset visual processing problems such as double vision, convergence insufficiency or tracking issues.
References:
When Should I Go See My Doctor
Anyone who has been bitten by a black-legged deer tick is at risk for Lyme disease. The highest risk groups include those living in or visiting endemic areas, especially people who spend significant time outdoors such as gardeners, hikers, or outdoor workers.
Patients should seek advice from their doctor if they have a suspicious round expanding red skin lesion, and/or show signs of summer-flu, particularly during Lyme disease season, which is highest-risk late spring through July/August. If those circumstances apply or symptoms persist it is very important to go to a physician.
For the west coast and other more temperate regions Lyme disease can be a year-round concern.
In the later disseminated stages, Lyme disease can be a much more insidious and complex illness. An individual should seek medical care if experiencing symptoms such as prolonged fevers, unexplained fatigue, painful joints, new or unusual headache, or heart or neurologic symptoms. If unexplained viral-like symptoms last for more than 1-2 weeks, please seek the advice of a physician.
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What Is Lyme Disease
Each year an estimated 300,000 people are infected with Lyme disease. Youre more likely to get Lyme disease if you spend time in grassy or wooded areas. The infection is spread through a bite from a deer tick. A characteristic bulls-eye rash is an early sign. Other symptoms at the early stages include:
- Chills
- Cognitive difficulties
Can Lyme Disease Affect The Optic Nerve
While Lyme disease can affect the eyes at any stage, the changes made to the optic nerve typically occur in the late stages of disease. Since the bacteria can cause inflammation, the optic nerve can become damaged or affected by that inflammation.
Inflammation of the eye can cause issues with the optic nerve which, in the worst case, could lead to vision loss. When this type of eye inflammation and nerve damage occurs, a person with Lyme disease may experience symptoms such as pain, color and vision loss, and seeing flashing lights.
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Visual Treatment Of Lyme Disease
Medical treatment for Lyme disease doesnt always address Lyme-related visual problems, and without treatment, vision may still be impaired long after medical treatment is completed.
Any inflammation in the body can negatively affect the functioning of the limbs and organs. This is especially true for the brain and the visual system, which are often affected by Lyme disease.
Thats where neuro-optometry can help.
Neuro-optometry evaluates how our eyes and brain function together. When Lyme disease affects that connection, a patients balance may be affected, causing their vision and depth perception to be affected as well.
A neuro-optometrist may utilize lenses, prisms and, in some situations, neuro-visual therapy. Neuro-visual therapy is a rehab program for those who have had a neurological incident that has affected their vision and its functioning/processing.
This is especially true in the case of children. Lyme disease can disrupt important developmental cycles, resulting in visual problems and the likelihood of developmental delays and learning difficulties.
If you or your child has been diagnosed with Lyme disease, contact Southwest Family Eye Health Center, to learn whether it has affected your vision.
Southwest Family Eye Health Center serves patients from Fort Worth, River Oaks, Westover Hills, and Dallas, Texas and surrounding communities.