Can Lyme Disease Affect the Eyes? Uveitis, Inflammation, and Treatment
Lyme disease can affect the eyes.
Inflammation may not respond to steroids.
But it may improve with antibiotics.
Lyme disease can affect the eyes and cause inflammation, including uveitis.
Symptoms may include blurred vision, eye pain, light sensitivity, and visual disturbances.
In some cases, eye inflammation does not respond to steroids—but improves with antibiotics when infection is involved.
Can Lyme Disease Cause Eye Problems?
Yes, Lyme disease can cause a range of eye problems.
These may include:
- Uveitis (inflammation inside the eye)
- Blurred vision
- Double vision
- Light sensitivity
- Eye pain
Eye symptoms may occur with or without other classic signs of Lyme disease.
What Is Lyme-Associated Uveitis?
Uveitis is a form of eye inflammation that can be caused by Lyme disease.
Although uncommon, it is a recognized manifestation of Borrelia burgdorferi infection.
It may be mistaken for other inflammatory eye conditions.
When to Suspect Lyme-Related Eye Inflammation
Lyme disease may be considered in patients with eye inflammation who have:
- A history of tick exposure or outdoor activity
- Systemic symptoms such as fatigue or joint pain
- Neurological findings
- Eye inflammation that does not respond to steroid treatment
This pattern may suggest an underlying infection rather than a purely inflammatory condition.
What the Study Found
In a retrospective study of 430 patients with uveitis, seven were identified as having Lyme-associated uveitis.
Most had a history of forest exposure, though only two recalled a tick bite.
Some also had additional Lyme-related findings:
- Erythema migrans rash
- Arthritis
- Lymphocytic meningitis
This highlights how Lyme disease may involve both the eyes and other systems.
Why Diagnosis Can Be Missed
Testing was not always definitive:
- PCR testing was negative in several cases
- Ocular testing was also negative in some patients
This means Lyme disease may still be present even when tests are negative.
Diagnosis often depends on clinical judgment and response to treatment.
Lyme Disease Eye Treatment
Lyme disease eye treatment typically includes antibiotics when infection is suspected.
In the study, all seven patients failed steroid treatment alone but improved with antibiotics.
- Most received intravenous ceftriaxone
- One was treated with oral doxycycline
This contrast—steroid resistance but antibiotic response—is a key clinical clue.
Clinical Takeaway
Lyme disease can cause eye inflammation, including uveitis.
When eye symptoms do not respond to steroids, Lyme disease should be considered—especially in patients with possible exposure.
Recognizing this pattern can lead to appropriate treatment and improvement.
Related Articles
References
- Bernard A, et al. Diagnosis of Lyme-associated uveitis. Br J Ophthalmol. 2017.
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 have PTLDS that has affected r eye showing uveitis
And left knee with osteoarthritis and little cartilage left and severe pain, myalgia. Orthopedics wants to replace knee and 3 eye Doctor’s does not know what to do for constant pain and feeling like object in r eye and photosensitivity. Help
I have patients who were diagnosed with PTLDS whose illness resolved with treatment for a persistent infection. I advise my patients to work with their other doctors to assess for other diagnoses