Springtime is here and summer is right around the corner. As we get into these two seasons our outdoor activities increase significantly. It is important to recognize that as the days become longer we are exposed to more sunlight as well as other outdoor elements such as allergens. Most people are aware that it is very important to protect your eyes form exposure to UV light (sunlight) because it is believed that increased and long term UV light exposure can play a role in cataract formation, macular degeneration, and conjunctival growths such as pterygia. Sunlight or UV light can also induce recurrent Ocular Herpes Simplex (cold sore on your eye) and Herpes Zoster (shingles).

Others suffer greatly from ocular allergies this time of year. Allergens from blooming vegetation affect approximately 60% of the population with some form of itchy eyelids, watery eyes or allergic conjunctivitis. It is important to keep these things in mind and be prepared to visit your Optometrist if you believe you might be experiencing any of these conditions.

Something that is not as common as these conditions however, seen more frequently than years past, is ocular infection and inflammation from Lyme disease. Lyme disease is a tick-borne disease that often goes unrecognized until it has affected many parts of the body, including the eyes.

The classic early sign of Lyme disease is a large "bull's-eye" rash that typically occurs at the site of an infected tick bite. Along with the rash, people often experience a mild flu-like illness. However, the initial rash frequently occurs on parts of the body that people don’t usually check, so the infection is often missed and goes untreated.

Up to 50 percent of patients with Lyme disease do not remember the initial rash or being bitten by the tick. Therefore, some people do not receive treatment right away. Without treatment, the infection can spread through the bloodstream into the joints, brain, eyes, and/or heart. Excruciating headaches may occur.

Arthritis occurs in many persons with Lyme disease, usually six months or longer after the tick bite. Four to eight percent of those with the disease develop cardiac involvement, usually heart block. This can in rare instances be fatal.

Fortunately, involvement of the eye is uncommon in Lyme disease however; the eyes can be affected in many different ways by the disease. In the early stages of the disease, many persons have conjunctivitis. In this condition commonly called pink eye, the eyes are red and uncomfortable, and there is a mucous or pus like discharge. Unlike many forms of conjunctivitis, the type that occurs in Lyme disease is not contagious.

In later stages of the disease, inflammation of various parts of the eye may develop. These include the uvea, the middle layer inside the eye; the cornea, part of the outer coat of the eye; the iris, the colored circle around the pupil, and the choroid, a layer of blood vessels in the eye. Ocular symptoms can include sensitivity to light and floaters. Inflammation of the optic nerve (optic neuritis) can also occur.

In the early stages of Lyme disease when the rash is apparent, the bacterial infection is treated successfully with oral antibiotics. These include doxycycline or tetracycline. In late stages, when eye disease, arthritis or neurologic disease is present, therapy consists of intravenous antibiotics (e.g., penicillin or ceftriaxone). However, in late stages antibiotics may be effective only to a certain extent or may even fail to work. In these cases, neurologic damage may progress or blindness may result.

Although much is now known about Lyme disease, better ways to diagnose and treat it are still needed. Early recognition of the symptoms is important in avoiding severe medical problems later. The primary reason it is difficult to diagnose is because many patients are unaware of the tick bite or the rash (if they had it). Another problem is that some of the nervous system signs and symptoms can mimic another disease, multiple sclerosis. When we suspect 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 people are misdiagnosed as having Lyme disease, while others are suspected but never confirmed.

In the event you experience eye related problems and end up at your eye doctors it is important to think about how you feel and how you have felt over the last few months. Be sure and offer symptoms that you may not even think have anything to do with the eye. This type of information aids in diagnosis. By looking at a patients history over several months doctors can better determine if you have garden variety conjunctivitis or eye inflammation or perhaps something more serious like Lyme disease. Certainly if you have a tick bite with a rash tell your doctor immediately and prophylactic treatment with antibiotics can be initiated.

If you have any questions concerning Lyme disease and your eyes please contact our office in Stillwater @ 405-372-1715 or Pawnee @ 918-762-2573.