Can Lyme Disease Affect Vision in Children? Papilledema Explained
Your child has headaches or blurred vision—but no clear cause.
Tests don’t fully explain it.
Lyme disease may be part of the picture.
Most people don’t associate Lyme disease with vision problems. But in some cases, children develop blurred vision, double vision, or headaches due to swelling of the optic nerve.
This condition—called papilledema—can occur in Lyme disease and may be missed if the connection isn’t recognized.
Learn more in our Lyme disease symptoms guide, where neurologic and multisystem symptoms are explained in context.
In their study, Vithayathil and colleagues examined 44 children with vision complications who were later diagnosed with both papilledema and Lyme disease (Vithayathil et al., 2024).
The authors report that papilledema related to intracranial hypertension occurs in approximately 6–7% of children with neurologic Lyme disease.
This is another example of how Lyme disease can present in unexpected ways—and be overlooked when symptoms don’t fit the usual pattern.
What Symptoms Do Children With Lyme-Related Vision Problems Have?
What did this look like in real patients?
The children, ages 1–18, were treated at the Children’s Hospital of Philadelphia between 1995 and 2019 and met CDC criteria for Lyme disease.
Most symptoms developed during the summer months.
- Headache (68%)
- Diplopia (double vision) (57%)
- Nausea and vomiting (48%)
In this study, children with Lyme-related papilledema commonly presented with headache, double vision, and nausea (Vithayathil et al., 2024).
In 95% of cases, papilledema affected both eyes.
Additionally, 66% of children had at least one cranial nerve abnormality—most commonly sixth nerve palsy, which affects eye movement.
On average, children sought care about 20 days after symptoms began—highlighting how easily these symptoms can be delayed or misinterpreted.
How Are Lyme-Related Vision Problems Treated?
Treatment typically included antibiotics:
- 39% received oral antibiotics (median 14 days)
- 55% received IV antibiotics (median 18 days)
Medications included doxycycline, amoxicillin, cefuroxime, and IV ceftriaxone.
Most children recovered. Among those with follow-up, 86% had complete resolution.
However, a small number had persistent neuro-ophthalmic symptoms.
- Papilledema may occur with or without cerebrospinal fluid abnormalities
- Vision-related findings were often the last symptoms to improve
When Should Lyme Disease Be Considered in Vision Problems?
Lyme disease should be considered when vision symptoms occur along with headache, neurologic symptoms, or recent exposure in endemic areas.
For example, a 10-year-old boy with Lyme disease developed blurred vision, eye pain, and redness after travel. His symptoms resolved following treatment.
This is where recognizing the pattern matters. Vision problems alone may not immediately suggest Lyme disease—but in the right context, they can be an important clue.
If vision symptoms don’t make sense, it’s worth asking why—again.
References
Vithayathil, J., Virupakshaiah, A., Liu, G., Swami, S. K., Avery, R. A., Liu, G. T., & McGuire, J. L. (2024). Lyme disease and papilledema: A retrospective study on clinical characteristics and outcomes. Journal of Child Neurology, 39(9–10), 334–342. https://pubmed.ncbi.nlm.nih.gov/39221464/
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
