Typically, our summer-time tips center around UV protection with sunglasses, eye injuries and infections common to the warmer months, and eye safety during Fourth of July activities. Something that is not as common as these conditions, however, 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. Fortunately, according to the Oklahoma State Department of Health, over 90 percent of Lyme disease cases are reported in northern portions of the United States. Oklahomans that travel to states north of us like Missouri, Kansas, and Illinois usually get exposed to Lyme disease from a tick bite there. However, recently officials have reported discovering some ticks in Oklahoma that carry Lyme disease. In most cases, it takes ticks 36-48 hours to transfer Lyme disease so if you spot a tick, get it off as soon as possible.
(Proper tick removal: https://www.youtube.com/watch?v=27McsguL2Og)
The classic early sign of Lyme disease is a large “bull’s-eye” rash that 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 do not usually check so the infection is often untreated.
Up to 50 percent of patients with Lyme disease do not remember the initial rash or tick bite. Therefore, most 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 rarely this can be fatal.
Involvement of the eye in Lyme disease is fortunately uncommon. In the early stages, people can have conjunctivitis. With conjunctivitis the eyes present red and may have a watery or 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 is 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, 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 called optic neuritis 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 is best treated with oral antibiotics. Doxycycline or Tetracycline are both effective. 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 known about Lyme disease, better ways to diagnose it early 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 at 405-372-1715.We also invite you to visit our website at www.cockrelleyecare.com and like us on Facebook at Cockrell Eye Care Center!