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Lyme disease has been related to a broad vary of visible issues together with conjunctivitis, episcleritis, keratitis, uveitis, neuroretinitis, and retinal vasculitis. Sufferers with Lyme-related eye problems could expertise blurred imaginative and prescient, eye ache or discomfort, visible floaters, double imaginative and prescient, eye flashes, crimson eye, headache, or sensitivity to mild.
Lyme disease is often related to flu-like signs or neurologic problems however an an infection with Borrelia burgdorferi (the causative agent of Lyme disease) may trigger issues along with your eyes. Of their article, “Co-infectious Uveitis With Syphilis and Lyme Disease: A Case Report,”¹ Mandal and colleagues describe what they imagine is the primary documented case of a affected person with concurrent co-infection of syphilis and Lyme disease who developed uveitis (an irritation of the center layer of the eyeball).
Uveitis is brought on by infections, autoimmune circumstances and trauma. And though Lyme disease and syphilis have been recognized to affect the eyes and trigger problems, these infections sometimes don’t trigger uveitis.
Diagnosing uveitis and treating it promptly are crucial, since sufferers are in danger for imaginative and prescient loss, in accordance with the authors. Sufferers with extreme eye problems are sometimes handled with tetracycline or beta-lactam antibiotics with/with out steroids.
Case report: Lyme disease causes eye issues
A forty five-year-old lady was admitted to the emergency division with a extreme bifrontal headache related to left eye ache and blurred imaginative and prescient in the correct eye with floaters and clear fluid oozing from each eyes.
Just a few weeks earlier, she developed rashes on her palms, the soles of her ft and torso. However there was no recognized historical past of tick bites.
“The affected person didn’t have any typical signs associated to Lyme disease or syphilis on the preliminary presentation.”
Laboratory testing confirmed the analysis of panuveitis with out macular edema or vasculitis and the lady started therapy with steroids and atropine eye drops.
Nevertheless, her signs didn’t enhance.
Just a few days later, she developed a fever, sore throat, and generalized lymphadenopathy. She reported having hepatitis C with the final therapy obtained one yr earlier.
“To find out the underlying trigger, a serological check for Borrelia and syphilis was carried out,” the authors state.
Take a look at outcomes have been optimistic for each Lyme disease and syphilis.
And the lady was handled with intravenous penicillin and oral doxycycline. At discharge, her signs had considerably improved.
Authors conclude:
- “Though Lyme disease and syphilis screening shouldn’t be routinely carried out for each case of uveitis, serology ought to be thought of on a case-by-case foundation when there’s a excessive suspicion of those infections.”
- “Concurrent co-infection of syphilis and Lyme disease is an uncommon prevalence and may be related to poor visible outcomes if therapy is delayed.”
- “Regardless of the choice for administering intravenous ceftriaxone in treating Lyme-uveitis, this affected person responded properly to a few weeks of oral doxycycline.”
- “… recurrence following therapy of Lyme-associated uveitis is frequent (4 out of seven sufferers) and should require second antibiotics.”
Case report: Lyme disease impacts the eyes of a 10-year-old boy
After vacationing in an space endemic for Lyme disease, a 10-year-old boy developed issues together with his eyes, which included sharp, bilateral eye ache, blurred imaginative and prescient and elevated redness in his eyes over a 3-day interval. Nevertheless, he didn’t report having any tick bites.
Three months previous to presenting, he reportedly had gentle, intermittent eye redness with none ache.
One month earlier than he started having a rise in eye issues, the boy skilled “a short generalized sickness with fevers, headache, and cervical/post-cervical and submandibular lymphadenopathy,” the authors state.²
An examination and check outcomes revealed he had uveitis as a consequence of Lyme disease.
“Early identification of Lyme-associated uveitis is essential to provoke applicable therapy and forestall long-term problems,” the authors state.
“This case illustrates the significance of sustaining a excessive suspicion for Lyme disease in sufferers with uveitis if there’s a report of current journey to Lyme-endemic areas.”
The boy’s signs fully resolved following therapy with a 2-month course of doxycycline and a prednisone taper. “A medical examination confirmed no remaining indicators of intraocular irritation,” the authors state.
Authors conclude:
- “Lyme-associated uveitis, although unusual, can result in severe problems.”
- “Lyme-associated uveitis ought to be thought of in any affected person presenting with new-onset uveitis after journey to a Lyme-endemic space.”
- “An in depth historical past ought to deal with potential publicity and any signs outdoors of eye-related points, although ocular involvement may be the only real manifestation of Lyme an infection.”
References:
- Mandal S, Tayyab H, Mandal S C, et al. (April 19, 2024) Co-infectious Uveitis With Syphilis and Lyme Illness: A Case Report. Cureus 16(4): e58608. doi:10.7759/cureus.58608
- Andrew DesLauriers, BA; Marissa Larochelle, MD. Lyme Illness-Related Uveitis: A Case Report and Overview Emphasizing the Significance of Journey Historical past and Geographic Concerns. August 9, 2023. Moran CORE. Scientific Ophthalmology Useful resource for Schooling.
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