Vision + Lyme Disease

It’s a growing problem, especially in late Spring and early Summer. It’s important enough, in fact, that the subject will be addressed at the AOA’s Optometry’s Meeting later this month.

Tip: As average temperatures rise and more regions are experiencing wet conditions, cases of Lyme disease are rapidly spreading.

300,000the cases of Lyme Disease diagnosed each year.

So, how big a problem is Lyme Disease? According to the Centers for Disease Control, the incidence of tickborne diseases increased more than two-fold between 2004 and 2016. Those numbers continue to increase as average temperatures continue to rise in the U.S.


Lyme disease is the result of a bacterial infection transmitted by a tick bite. Named for the Conn. town in which the first case was reported in the mid-70’s, most cases are still seen in the Northeast and Midwest. As average temperatures rise across the country and more regions are experiencing very wet conditions, experts note that cases are rapidly spreading well beyond those regions. Hence the need for ECPs, of course, but also staff in practices across the country to understand what to look for and what to ask patients.


Ticks infect both white-tailed deer and white-footed mice.  Humans are exposed when they come into contact, usually on grasses or leaves, where these ticks have landed. The ticks spread a spiral bacterium, called Borrelia burgdorferi, that causes Lyme. As the deer population spreads to more suburban areas, Lyme disease spreads with it.


The one thing most people recognize is the often-bullseye-shaped rash (erythema migrans). If untreated by antibiotics, that’s often followed by symptoms that mimic the flu as the disease spreads to joints, the brain, heart, and eyes. Bells Palsy (paralysis of one side of the face) and arthritis are not uncommon in untreated patients.


The path, if untreated, can be a devastating one.

• EARLY: Non-contagious conjunctivitis, photophobia, double vision, headaches, visual fatigue.

• LATER: According to the University of Illinois College of Medicine, “Inflammation of the eye may develop. Parts of the eye that may be affected include the uvea, iris, and choroid. Ocular symptoms can include sensitivity to light and floaters.”

• ADVANCED: Optic neuritis (Inflammation of the optic nerve) may occur, resulting in vision loss. Loss can also occur as a result of inflammation in the brain.)


Easy in early stages, patients may not respond to treatment later.

EARLY: Oral antibiotics, including doxycycline or tetracycline.

LATE: Intravenous antibiotics may help until very late stages, when neurologic damage has progressed, potentially resulting in blindness.

According to the American Academy of Ophthalmology, oral antibiotic treatment can be followed up with topical corticosteroids and mydriatics.

Have you seen an uptick (pun intended) in cases of Lyme Disease among your patients and the community at large? If so, tell us about it and share in the conversation on Facebook here.

Erinn Morgan