Can Lyme Disease Affect Your Eyes? Symptoms, Blurry Vision, and Vision Loss
Lyme disease can affect the eyes in several ways
Blurred vision is more common than severe vision loss
Early diagnosis and treatment may help preserve vision
Most people think of Lyme disease as causing a rash, joint pain, or facial paralysis. But Lyme disease can also affect the eyes.
Most patients with Lyme disease never develop eye complications, but ocular involvement is a well-documented manifestation that clinicians should recognize because timely diagnosis and treatment may improve outcomes.
Although ocular Lyme disease is uncommon, published reports describe blurred vision, optic neuritis, uveitis, double vision, retinal inflammation, conjunctivitis, and other eye problems. Prompt recognition is important because many patients improve with appropriate antibiotic treatment and ophthalmologic care.
A recent article published in the Wisconsin Medical Journal describes the case of a 46-year-old woman who experienced sudden bilateral vision loss and paresthesias.
A Case of Lyme Optic Neuritis
According to Jha and colleagues from the Medical College of Wisconsin, the woman developed blurred vision that progressively worsened over a three-week period following upper respiratory symptoms.2
She also experienced nausea, weakness, dizziness, and tingling or numbness in her lower extremities.
“After extensive workup, she was diagnosed with Lyme optic neuritis based on the clinical presentation and positive serology,” writes Jha.
Optic neuritis is inflammation of the optic nerve. It typically causes temporary vision loss in one eye and is more commonly associated with multiple sclerosis. Lyme disease is a much less common cause but should remain part of the differential diagnosis in appropriate clinical settings.
In this case, the patient’s vision loss was severe. Using Snellen eye charts, her visual acuity measured 20/400 in both eyes. Color vision was impaired, and a dilated fundus examination demonstrated bilateral optic disc edema, hyperemia, and optic nerve elevation concerning for intracranial hypertension.
Other possible causes were carefully excluded.
“The inpatient workup ruled out posterior reversible encephalopathy syndrome, idiopathic intracranial hypertension, multiple sclerosis, meningitis (viral, fungal, tuberculosis, syphilis, and other bacterial), autoimmune process and cerebrovascular disease,” Jha states.
What Eye Problems Can Lyme Disease Cause?
Lyme disease can affect multiple structures within the eye and visual system.
Published reports have described:
- Blurred vision
- Optic neuritis
- Uveitis
- Conjunctivitis
- Keratitis
- Retinal inflammation
- Optic disc swelling, also called papilledema
- Double vision from cranial nerve palsies
- Reduced color vision
- Vision loss
Although these complications are uncommon, they illustrate that Lyme disease may involve both the eye itself and the nerves responsible for vision. Learn more about ocular Lyme disease and other eye-related manifestations.
Can Lyme Disease Cause Blurry Vision?
Yes. Blurred vision has been reported in patients with ocular Lyme disease and may occur with optic neuritis, uveitis, retinal involvement, or inflammation affecting the optic nerve.
Because blurred vision has many possible causes, Lyme disease should be considered in patients with compatible symptoms, tick exposure, or other features suggestive of Lyme disease symptoms.
Can Lyme Disease Cause Uveitis?
Yes. Although uncommon, uveitis has been reported in patients with Lyme disease and is one of the recognized ocular manifestations described in published reviews.
Uveitis is inflammation of the middle layer of the eye and may cause eye pain, redness, blurred vision, floaters, light sensitivity, and decreased vision.
Because untreated uveitis can threaten vision, prompt evaluation by an ophthalmologist is important. Lyme disease should be considered among the possible causes in patients with compatible symptoms, epidemiologic risk factors, and supportive laboratory findings.
Can Lyme Disease Cause Vision Loss?
Vision loss has been reported in Lyme disease but is uncommon.
Most patients with Lyme-related eye disease do not become blind. However, inflammation involving the optic nerve or other ocular structures may lead to significant visual impairment if diagnosis and treatment are delayed.
Several published case reports describe substantial improvement following antibiotic treatment, highlighting the importance of early recognition.
How Is Ocular Lyme Disease Diagnosed?
Diagnosis usually requires a combination of clinical history, eye examination, neurologic assessment, Lyme disease testing, and careful exclusion of other causes.
An ophthalmologist or neuro-ophthalmologist may evaluate visual acuity, color vision, eye pressure, the retina, optic disc swelling, visual fields, and signs of uveitis or retinal inflammation.
Depending on the presentation, clinicians may also consider Lyme serology, spinal fluid testing, MRI, or additional testing for autoimmune, infectious, inflammatory, or demyelinating disorders.
Conditions That Can Mimic Lyme Eye Disease
Lyme-related eye disease can resemble several other conditions, which is why careful evaluation is important.
Possible mimics include multiple sclerosis, autoimmune uveitis, neuromyelitis optica, MOG antibody disease, viral infections, syphilis, sarcoidosis, idiopathic intracranial hypertension, and other inflammatory or neurologic disorders.
Because neurologic Lyme disease can overlap with other neurologic and inflammatory conditions, the diagnosis should be based on the full clinical picture rather than eye symptoms alone.
Clinical Perspective
In my clinical practice, I have cared for patients with Lyme-related uveitis. Recognizing Lyme disease as a possible cause and referring patients promptly to an ophthalmologist or neuro-ophthalmologist can be important because early diagnosis and treatment may help preserve vision.
Treatment and Outcome
The woman fulfilled the criteria for acute Lyme disease with positive two-tier serologic testing.
“Our case also fulfilled the criteria for acute Lyme disease with strong evidence of a causal link with optic neuritis, as described by Sibony,” Jha writes.
The patient began doxycycline therapy and reported improvement in her vision after one week of treatment.
Unfortunately, she was subsequently hospitalized for alcohol intoxication, left against medical advice, and did not return for follow-up.
“Whether her symptoms resolved completely thereafter is unknown,” the authors conclude.
Why Early Recognition Matters
Because ocular Lyme disease is uncommon, patients may initially undergo evaluation for multiple sclerosis, autoimmune disease, viral infections, or other neurologic disorders before Lyme disease is considered.
Recent reviews emphasize that prompt diagnosis, appropriate antibiotic therapy, and ophthalmologic evaluation may improve visual outcomes.
Frequently Asked Questions
Can Lyme disease affect your eyes?
Yes. Although uncommon, Lyme disease can affect the optic nerve, retina, uvea, conjunctiva, cornea, and cranial nerves controlling eye movement.
Can Lyme disease cause blurry vision?
Yes. Blurred vision has been reported with optic neuritis, uveitis, retinal inflammation, and other ocular manifestations of Lyme disease.
Can Lyme disease cause vision loss?
Yes. Significant vision loss has been reported, although permanent blindness is uncommon. Early diagnosis and treatment may improve outcomes.
Can Lyme disease cause uveitis?
Yes. Lyme disease has been reported as an uncommon cause of uveitis. Patients with unexplained eye inflammation, blurred vision, floaters, eye pain, or light sensitivity should be evaluated by an ophthalmologist to determine the underlying cause.
Can Lyme disease cause floaters?
Floaters can occur with many eye conditions, including uveitis and other inflammatory eye disorders. Lyme disease is an uncommon cause, but it may be considered when floaters occur with compatible symptoms, exposure risk, or other signs of ocular inflammation.
What is Lyme optic neuritis?
Lyme optic neuritis is inflammation of the optic nerve associated with Lyme disease. It may cause blurred vision, impaired color vision, eye pain, or vision loss.
Clinical Takeaway
Lyme disease can affect the eyes in a variety of ways, including blurred vision, optic neuritis, uveitis, retinal inflammation, and, rarely, significant vision loss.
Because ocular Lyme disease may mimic multiple sclerosis and other neurologic or inflammatory disorders, it should remain part of the differential diagnosis in patients with compatible symptoms and tick exposure.
Early recognition, appropriate antibiotic treatment, and prompt referral to an ophthalmologist or neuro-ophthalmologist may improve visual outcomes.
Related Articles
These articles explore Lyme-related eye symptoms, neurologic complications, and other tick-borne disease eye problems.
Eye problems in tick-borne diseases other than Lyme
Growing list of eye problems in Lyme disease
Six cases of neuroinvasive Lyme disease
Lyme disease misdiagnosis
References
- Sathiamoorthi S, Smith WM. The eye and tick-borne disease in the United States. Curr Opin Ophthalmol. 2016;27(6):530-537.
- Jha P, Rodrigues Pereira SG, Thakur A, Jhaj G, Bhandari S. A Case of Optic Neuritis Secondary to Lyme Disease. WMJ. 2018;117(2):83-87.
- Lu Y, Zand R. Characteristics of Lyme optic neuritis: a case report of Lyme associated bilateral optic neuritis and systematic review of the literature. BMC Neurol. 2022;22:113. doi:10.1186/s12883-022-02627-z.
- Boubga T, Hafessi A, Benameur B, Assoufi N. Isolated Optic Neuritis Revealing Lyme Disease in an Adolescent: A Case Report and Literature Review. Cureus. 2025;17(12):e98396. doi:10.7759/cureus.98396.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I’m curious why BRAO wasn’t mentioned as an eye problem with Lyme and coinfections. I was diagnosed 4 years post onset of symptoms, 1 year into treatment I had sudden onset of left eye blindness. Head CT done, vascular work up with sonography, all negative. LLMD told me cause was biofilm.
BRAO has been reported in Lyme disease in the the published literature. There are often findings that have been published but do not make it on a list. Your comments remind us all to include Lyme disease in a growing number of eye findings.
“The central retinal artery, a branch of the ophthalmic artery, enters the eye through the optic disc and divides into multiple branches to perfuse the inner layers of the retina. A branch retinal artery occlusion (BRAO) occurs when one of these branches of the arterial supply to the retina becomes occluded.” according to emedicine.
I was diagnosed in 2015 and still have bells palsy, bad anxiety, and terrible vision. I started getting many cysts on my skull. I’ve also, after diagnosis, become very angry and impatient with absolutely no filter. Heart palpitations which went on for years. I’ll be 34 this week and my face will be like this forever. I was told I have 5th and 7th cranial nerve damage. My short term memory is non existent and I hate it.
I was diagnosed with neurological lyme disease in the spring of 2016 after being misdiagnosed for 11 years. I was originally diagnosed with a spider bite at an urgent care facility in the Spring of 2005. I live approximately an hour Southeast of Knoxville, Tennessee. I have had blurred vision for many years. I have had 5 PICC lines with many months of IV antibiotics in the past 5 years. This past Saturday I fell and hit my head. I had sudden vision loss in my left eye. CT at the ER ruled out a concussion. ER physician referred me to a local optometrist who diagnosed me with a server case of optic neuritis. I told him I have neurological lyme disease, but he was adamant that I most likely have MS. I am scheduled with a retinal specialist at 10 a.m. this morning from the University of Tennessee at Knoxville. His name is Dr. Barb and I hope he listens to me when I tell him that I have neurological lyme and thinks outside the box. I am terrified my vision will not return in my left eye. There is so much diminished color and my central vision is all grey. My cognitive function has diminished since the fall and my short term memory is almost non existent. I am so glad I found this article and will show it to Dr Barb and insist that the optic neuritis is caused by lyme. I was misdiagnosed for too many years to sit quietly and accept the standard diagnosis and protocol.
I was diagnosed with a spider bite around 2004- got progressively worse over the years and finally diagnosed with Lyme and coinfections in 2008. It’s been a battle since. I’ve had 3 episodes of optic neuritis – in the middle of one right now. I’ve had two PICC lines in the past. While long term antibiotics have helped each time, I’ve also permanently lost some vision each time. I’m terrified that soon I will just be completely blind with no options. My color vision in both eyes is horrendous and I’ve noticed a major change in depth perception. I’ve seen some of the best optic neurologists out there and nobody has answers. Praying we all find answers to this.
Praying for you Rachel the Lord hears your prayers and sees your tears
Many years living in the eastern US where ticks are prolific, I have had multiple bites over the years. There was one specific bite at the base of the hairline around 2005 that still to this day gets a raised painful spot every few months as if there is a connection with that tick bite. I also started getting quite unwell around that time and begannto have vision issues. To make a long story short, I’ve searched for many years for answers. Being tested for Lyme, lupus autoimmune…. And finally 2 years ago an eye specialist after visiting many over the years, diagnosed atopic kerato conjunctivitis. One eye has lost vision. All I see is white and they said it is scar tissue. I’ve been rushed to ER more than once during episodes. There is a strong feeling this is actually Lyme associated, but after so many years have had too much damage.
I often see patients who have chronic irritation at the site of a tick bite without Lyme disease. I advise my patients to look a second time at Lyme disease even if the tests are negative. There are often other problems that help with the diagnosis.
After noticing a small mark on my neck last May 2020 I have suffered from well over 80 symptoms with every area of my body affected no diagnosis, infection in stomach only positive test not been believed now my eyes are been affected I worry for my future
My 7 year old son has contracted Lyme. After 2 weeks he lost 5lb. We went to the ED fluids and blood tests and sent home. Pedestrian changed antibiotics from amoxicillin to doxycycline. Within a few days my son seen double vision, then 1 day later he was blind. Went to ED they again gave fluid and blood tests. Then released him as dehydrated and follow up with pedestrian. We mentioned meningitis 2 days later at pedestrians office and 2 days after that they finally got my son to a Children’s Hospital. My son for regain some Central vision but other than that, not much. Every day is a struggle so far can’t move his neck, today he had headache, and choked and vomited, not sure if I’m going back to the hospitals. So scary for parents and patients.
Evan, I’m so sorry to hear about your son’s loss of vision, as well as his other severe symptoms. Have you tried to find a Lyme-literate doctor in your area? These truly are the only healthcarr professionals that have a clue about Lyme and co-infections. There are many Facebook groups run by people with Lyme, which have given me the most reliable info. Rise Above Lyme, run by Jessica Devine, is my favorite. Dr. Cameron, of course, is a LLMD. Not sure if he is taking new patients, but his office may be able to refer you if he is not. Prayers that your son finds the right treatment and recovers completely.
I’ve recently been diagnosed with a macular pucker, and am facing surgery early next year if my vision continues to degrade in my right eye, which is currently 20/30. It is said to be correctible via surgery, to remove the vitreous layer, which should restore half of the vision I’ve lost by then. Just wondering if you’ve heard of other cases of macular pucker in other Lyme patients. I’m 64, and they are attributing this to aging. I’ve had symptoms since around 2014. Have Babesia, RMSF, Candidiasis, and mold toxicity (at a minimum). Have been unsuccessfully treated by 3 LLMDs. My husband was diagnosed in 2011 and has been in treatment since then, with somewhat greater success. My main symptoms so far have been fatigue and brain fog. Thanks so much for any info or thoughts you may have.
I have been treating lyme disease and probable co infections(symptoms of bartonella, babesia and ehrlichia with more very likely) on and off for close to 20 years. I was diagnosed with type 2 diabetes like 15 years ago, although I believe it to be diabetes 1.5(which is an autoimmune type of diabetes). My eyes have become blurry and my glasses prescription has gotten stronger over the years. I recently noticed blurry hairlike fibers that were dark in my left eye. I had this for several weeks and then woke up one day with a dark blurry spot in my right eye. I could tell it was likely blood as it was dark red around the edges. I made an appointment with an eye doctor and he said it was from my diabetes. I did tell him I had lyme and coinfections. He said that my retinas were not getting enough oxygen and therefore trying to grow new capillaries to bring more blood(therefore more oxygen) to my retinas. He said I needed laser treatments and possible injections(which I researched and found out it’s a chemo drug or steroid that they inject). I have had 2 laser treatments and have had nothing but problems with my eyes and head in general. My eyes feel swollen and my depth perception feels off. They water and are bloodshot all the time. I have had bad headaches daily and had trouble with other cranial nerves as well, such as drooling for no reason and my head sweating when I eat(I had this before my eye issues, but it has gotten worse). I also now have horrible tooth pain on the left lower side of my jaw. I am currently not being treated by an LLMD due to finances and not being able to work due to worsening of my lyme symptoms in general. I am treating with herbal supplements, but have just started(I have to ramp up very slowly or I get really bad herx reactions). I don’t know how to continue with treatment. Do I continue with these laser treatments and let them inject my eyes? I feel like this would be a big mistake. Do I wait and see if the herbal treatment will help? I know diabetes causes blindness and that lyme and coinfections can cause blindness, but is the treatment the same for both conditions? I am so confused and lost as to what to do. I don’t want to cause more problems.
I guess this means I am not getting a reply. I don’t know who else to ask.
I have had patients in my practice who have had to be treated for diabetic related complications. I have sometimes had to treat them for Lyme disease at the same time.
I can confirm temporarily blindness after a day of blurred vision. The Eye doctor send me away telling me that he cannot help. My GP did an iv. treatment over 20 days with 4g Ceftriaxon once a day. It solved the problem for a while. Now I get amoxi 1000mg 3x a day for one month whenever the blurred vision comes back. A eye scan showed changes never seen before.
Thanks for sharing. I am glad to hear vision has improved with antibiotics.
After four cases of lyme actually diagnosed (since late 80s) and treated at time of infection with the bullseye, it is likely I had more infections not diagnosed at the time it happened. I have been a camp instructor summers for 27 years. And live and vacation in PA VT NY MA VA and MD areas with extreme lyme infestations. Further complicated by having been exposed to the most intense pfiesteria bloom in the Chesapeake in the 90s I have both late stage lyme and the second parasite, hyper algae bacterial heterotrophic dynaflagellate infection also for over thirty years. That was diagnosed by the expert, JoAnn Burkholder, who has written the definitive papers on that parasite. Both have eye symptoms and for two decades I was diagnosed and treated for dry eye but none of those treatments worked. Finally it became clear it was not dry eye but these two parasite infections. Both cycle with outbreaks at different frequencies. Lyme breakouts occur about once a year. Pfiesteria on a more rapid cycle of two months or so. The symptoms are similar but I can tell which is which now and though I have tried many types of parasite cleansing it just is not enough to clear them. The latest outbreak for me presented with severe eye pain, tiny pupils, floaters, sensitivity to light and halos that are HUGE. Blurry vision as well. The headaches was so bad it may have been migraines and that is the only diagnosis conventional medicine has provided. Migraines with only rescue meds now in treatment when the Effexor they suggested caused many horrid reactions and side effects so had to go off that within the month. The first MRI at a low quality older machine at a small hospital regional to my home i had showed inflamation and possible tumor in the occipital lobe. I refused contrast on that MRI because it was the worst kind banned in the EU and my kidneys are not so great including kidney stones. I did a second contrast and non contrast MRI at a major player hospital an hour away that had the contrast that is mild enough to be given to patients with kidney disease for a second opinion and that MRI only two days after the first showed clear. Nothing of concern in occipital or anywhere. Only got to see a student in that follow up since it was normal and she was unconcerned with the lyme or parasite complication and barely able to make the cds from the two MRIs display on the computer let alone give me any real interpretation of what is going on. Pain and headaches continue and eye symptoms are still there but sort of wavering now in and out with more or less intensity, but the light sensitivity, pain in eyes and blurry vision do continue. The neurologists at original MRI site has also downgraded me to to just assistants with no access to the actual neurologist now going forward and diagnosis settled on migraines, again disregarding the lyme and parasite aspects of my condition. I requested a wills eye hospital consult to explore if lyme could be acting like late stage syphillis with the long term damage to the eyes. That consult is in April. Unless I lose vision in one or both eyes suddenly then they would see me sooner if I go to their emergency room. My vision is definitely worsening but so far hanging in there. The website below shows my camps and outdoor location of the site at a national park. There were six of us infected at the same time with the Pfisteria during the bloom on the Chesapeake and one died of seizures, and two, a mother and daughter both have MS diagnosis (that is what pfiesteria does to you when it gets late stage and when medical protocols of treatment [steroids for the most part and ms treatments] are followed on it). JoAnn and her colleagues who were exposed to the parasite no knowing it was airborne in the labs experienced the MS like symptoms and some some succumbed to it. Of my group of infected cohorts the mother with MS is in a wheelchair and was recently told to get her affairs in order as her system is shutting down. Me and one of the others have what looks like autoimmune and the cycle of outbreaks and have done best of all but still severely compromised with what I call death by a thousand paper cuts. Most of my help came from the natropathic options and since I am lucky enough to have good insurance I always do the conventional medicine options that my system can tolerate and make sure to see the medical doctors who basically disregarded the parasite component. But long ago I gave up steroid treatments because I could see they just made me worse next cycle or outbreak. I do monthly accupuncture which helps performed by my GP for the past five or six years who is the first doctor who took me seriously because he could see the cycles of outbreak symptoms I go through since I saw him once a month. I have been on many rounds of antibiotics but never the pic line or injectable versions. A chance prescription of ivermectin for a travel purpose notably shut down the outbreak cycles and when Covid came along and made them impossible to get as he was forbidden to prescribe even though my prescription was for Lyme not covid. So when I went off it all came back. Then when I finally could take that again I experienced a huge biofilm vomiting episode and the outbreaks with the exception of the eyes subsided again. It seems to keep it in check but not enough to really beat it back to the point of eradicating it. I wish I could afford the heat treatment for lyme. That seems to be the one thing out there that could help me with that but at 10 grand a session and two or three sessions needed to really beat it it is way out of my budget. Is that treatment something that may become available in the US? My understanding it is only available abroad. I am an artist and art teacher so losing my vision would be a huge blow to me.