Lyme disease causes vision loss in 46-year-old woman

There have been several case reports linking Lyme disease with eye problems, including a loss of vision. In a study by the Mayo Clinic, researchers concluded that "although ocular involvement can be self-limited, delays in diagnosis may result in vision impairment and even blindness." [1]

A recent article published in the Wisconsin Medical Journal describes the case of a 46-year-old woman who experienced a sudden onset of bilateral vision loss and paresthesias.

According to Jha and colleagues from the Medical College of Wisconsin, the woman developed blurred vision, which progressively worsened over a 3-week period. [2] This reportedly began after she had upper respiratory tract symptoms. In addition, the woman had nausea, weakness, dizziness, and tingling/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.

Lyme disease and related tick-borne illnesses can cause a sudden blurring of vision and other eye problems.

Optic neuritis is inflammation of the optic nerve. The condition typically causes temporary vision loss in one eye and is often associated with multiple sclerosis (MS).

In this case, the vision loss was significant. Using the Snellen Eye Test Charts her visual acuity was 20/400 in both eyes. Color vision was impaired in both eyes, as well. “A dilated fundus exam demonstrated bilateral optic head edema, hyperemia, and optic nerve elevation concerning for intracranial hypertension,” according to Jha.

Other conditions were ruled out. “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.

Eye problems in tick-borne diseases other than Lyme 

The woman fulfilled the criteria for acute Lyme infection with a positive 2-tiered serology test (positive immunoassay). “Our case also fulfilled the criteria for acute Lyme disease with strong evidence of a causal link with optic neuritis, as described by Sibony,” writes Jha.

[bctt tweet=”Lyme and other tick-borne diseases can cause eye problems, including vision loss and blurred vision. ” username=”DrDanielCameron”]

The woman was prescribed 2 weeks of doxycycline but after one week was admitted to the hospital for alcohol intoxication. “Upon questioning, she endorsed some improvement in vision after initiation of antibiotic,” writes Jha.

But the final outcome is uncertain, since the woman left the hospital against medical advice and did not adhere to her follow-up appointments. “Whether her symptoms resolved completely thereafter is unknown,” Jha states.

Growing list of eye problems in Lyme disease

The authors stress the need to include Lyme disease in differential diagnosis of optic neuritis. “More reporting of the cases is essential to draw enough attention from the clinicians and researchers to help devise evidence-based guidelines on the approach to diagnose and manage this condition.”

References:

  1. Sathiamoorthi, S. and W.M. Smith, The eye and tick-borne disease in the United States. Curr Opin Ophthalmol, 2016. 27(6): p. 530-537.
  2. 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.

21 Replies to "Lyme disease causes vision loss in 46-year-old woman"

  • Alana
    02/21/2024 (3:00 am)
    Reply

    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.

  • Carmen Seidel
    01/29/2023 (7:10 am)
    Reply

    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.

    • Dr. Daniel Cameron
      01/30/2023 (7:19 am)
      Reply

      Thanks for sharing. I am glad to hear vision has improved with antibiotics.

  • Yvonne
    05/27/2022 (1:26 am)
    Reply

    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.

    • Yvonne
      06/02/2022 (6:55 am)
      Reply

      I guess this means I am not getting a reply. I don’t know who else to ask.

      • Dr. Daniel Cameron
        06/04/2022 (4:55 pm)
        Reply

        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.

  • Alexandra Blond
    09/29/2021 (10:32 pm)
    Reply

    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.

    • Dr. Daniel Cameron
      09/30/2021 (6:53 am)
      Reply

      I am pleased that opthamologist are beginning to look at tick borne illnesses. I have written several blogs on the subject. I have not seen a macular pucker in my patients but I am not an ophthalmologist. I focus more on treating Lyme disease the best I can.

  • Evan
    09/11/2021 (9:36 pm)
    Reply

    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.

    • Alexandra Blond
      09/29/2021 (10:40 pm)
      Reply

      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.

      • Dr. Daniel Cameron
        09/30/2021 (7:01 am)
        Reply

        My office is taking new patients at 914-666-4665. There are a growing number of doctors who are considered LLMD’s.

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