Lyme Disease Eye Problems and Vision Changes
Lyme disease can affect the eyes and visual system in several ways. In their article,
“Contrast Sensitivity Loss in Patients With Posttreatment Lyme Disease,”
Rebman and colleagues reported that some Lyme disease patients experience impaired contrast sensitivity.1
Contrast sensitivity refers to the ability to distinguish objects from their background, particularly in situations with reduced visual contrast such as low light, fog, or glare. For example, safe nighttime driving requires good contrast sensitivity.
“It [contrast sensitivity] is especially strongly associated with reading performance, ambulation, mobility, driving, face recognition, and activities of daily living,” explains Arditi.2
The Rebman study found that patients with contrast sensitivity impairment had 2.6 times higher odds of belonging to the post-treatment Lyme disease (PTLD) group compared with patients without contrast sensitivity loss.
Contrast Sensitivity May Reflect Neurologic Lyme Disease
The authors concluded that contrast sensitivity impairment in patients with PTLD is associated with neurologic and cognitive symptoms and may serve as a marker of illness severity.1
Several studies have documented visual disturbances and eye problems in individuals with Lyme disease.
Visual Symptoms Reported in Lyme Disease
- Padula and colleagues described a young woman who developed visual processing problems related to Lyme disease.3
A 20-year-old woman presented for a neuro-optometric evaluation with complaints of headaches, eye strain (asthenopia), intermittent double vision, extreme light sensitivity, dizziness, and balance problems.
Her symptoms fluctuated daily and had persisted for approximately two years.
Further questioning revealed difficulty reading and performing near work due to double vision and headaches. She also experienced fatigue after reading and episodes of brain fog.
The patient reported difficulty tolerating crowded environments, which triggered anxiety and a sense of being overwhelmed. She also noted worsening attention span and cognitive difficulties affecting her school performance.
- Another study described a 46-year-old woman who developed sudden bilateral vision loss and paresthesias due to Lyme disease.4
-
Gibaud and colleagues
reported a 9-year-old girl
who presented with headaches and abnormal involuntary eye movements known as opsoclonus, along with facial nerve palsy.5
The child’s abnormal eye movements resolved following antibiotic treatment for Lyme disease.
READ MORE:
Visual changes in Lyme disease
Related Articles:
Erratic rapid eye jerks in a child with Lyme disease
References:
- Rebman AW, Yang T, Aucott JN, Mihm EA, West SK. Contrast Sensitivity Loss in Patients With Posttreatment Lyme Disease. Translational Vision Science & Technology. 2021.
- Arditi A. Improving the design of the letter contrast sensitivity test. Invest Ophthalmol Vis Sci. 2005.
- Padula WV. Lyme and Tick-borne Disease: Compromise of Visual Processing. Primary Care Optometry News.
- Jha P, Rodrigues Pereira SG, Thakur A, Jhaj G, Bhandari S. A Case of Optic Neuritis Secondary to Lyme Disease. WMJ. 2018.
- Gibaud M, Pauvert O, Gueden S, Durigneux J, Van Bogaert P. Opsoclonus in a child with neuroborreliosis. Arch Pediatr. 2019.
Poor contrast sensitivity is also associated with biotoxin illness, most often from mold growth in water damaged buildings. There is a subgroup of patients, about 25%, who genetically lack the ability to clear these toxins, even after leaving the building. Severe inflammation and immune dysregulation develop. Such patients have difficulty clearing tick borne infections, despite aggressive treatment. It is also difficult to distinguish between symptoms of ongoing Lyme disease and biotoxin illness. It is possible that some patients with PTLD are living or working in moldy environments. It is also possible that Lyme alone could cause changes in contrast sensitivity, as it also is inflammatory and affects the nervous system. A definitive test to detect on going infection would help greatly.