Typically our summer-time tips center around UV protection with sunglasses, eye injuries and infections common to the warmer months, and eye safety during 4th of July activities.  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.  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 migraine like headaches may occur.  Arthritis occurs in many with Lyme disease, usually six months or longer after the tick bite.  Four to eight percent of those with the disease can have heart problems and in rare instances this can 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 many people have conjunctivitis.  In this condition, commonly called pink eye, the eyes are red and uncomfortable, and there is a mucous discharge.  Unlike many forms of conjunctivitis, the type that occurs in Lyme disease is not contagious however, it can be recurrent until the appropriate diagnosis has been made.

In later stages inflammation of different layers of the eye may develop.  The cornea may be involved and result in light sensitivity and decreased vision.  The inside of the eye including the iris, or colored part of the eye, the retina, and the retinal blood vessels can have various degrees of swelling or inflammation resulting in pain, light sensitivity, floaters and usually a change in vision.  Swelling of the optic nerve may also occur.

Early detection and treatment is important in avoiding ocular involvement.  In the early stages of Lyme disease when a rash is apparent, the bacterial infection can be 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 given in a hospital setting.  Unfortunately, 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.  The primary reason for the difficulty is because many patients are unaware of the tick bite or a rash assuming it even occurs. Following outdoor activities always check yourself for ticks around your waistline and in folds of skin like your armpits and groin area.

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. We also invite you to visit our website at www.cockrelleyecare.com and like us on Facebook at Cockrell Eye Care Center!

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