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Lyme Disease and Your Eyes

lyme disease map cdc

Lyme disease and your eyes.



Lyme disease is an infection that is caused by a spirochete (a type of microorganism) 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 of the US and now also has a high incidence in Minnesota and Wisconsin.  The reported cases are represented by the blue dots in the CDC map above.

Lyme disease was first discovered in Old Lyme Connecticut in 1975.  It usually starts with a characteristic “bull’s eye” rash as demonstrated in this photo from the CDC.


lyme 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 which include red eyes that can look like full blown pink eye with eyelid swelling. It also can produce sensitivity to lights and inflammation inside the eye called iritis or uveitis.

Why Every Red Eye is not “Pink 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 heart, spleen, liver and kidneys.  

There are also several ways it can affect your eyes.  It can cause inflammation in your cornea (keratitis), retina (retinitis), optic nerve (optic neuritis), uveitis, inflammation in the jelly like substance that fills the back of the eye called vitreous (vitritis) and the muscles that move your eye around (orbital myositis).  It can also affect the eye if it causes problems with the nerve that controls your eyelid muscles so that your eye will not close properly (Bell’s palsy).

What can I do for my red, itchy eyelids?

There is a third phase of the disease that is caused by long term persistent infection.  This phase can create multiple neurologic problems and can appear very similar to the presentation of Multiple Sclerosis (MS). The eyes can show any of the same signs as phase two, but the most common presentation is persistent Keratitis.

The diagnosis is made by observing the presenting symptoms, being in an area where there is 

significant number of the disease carrying ticks, and a blood test which can confirm the diagnosis.  

The CDC recommends the following antibiotic regimens to treat the disease.

Age Category

Drug

Dosage

Maximum

Duration, Days

Adults

Doxycycline

100 mg, twice per day orally

N/A

10-21*

Cefuroxime 

axetil

500 mg, twice per day orally

N/A

14-21

Amoxicillin

500 mg, three times per day orally

N/A

14-21

Children

Amoxicillin

50 mg/kg per day orally, divided into 3 doses

500 mg per dose

14-21

Doxycycline

4 mg/kg per day orally, divided into 2 doses

100 mg per dose

10-21*

Cefuroxime axetil

30 mg/kg per day orally, divided into 2 doses

500 mg per dose

14-21

The symptoms and signs of Lyme Disease can mimic many other problems so it is important to keep Lyme Disease in mind if you are having multiple problems involving different organs and you know or have any suspicion that you may have had a tick bite while you were in areas where the disease is prevalent. 

Why Should I Get My Eyes Examined Even If My Vision Is Good?
What is a Freckle in the back of my eye?
Do I really need glasses if I have Contact Lenses?

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Sunday, 25 August 2019

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