Lyme Disease, MS, and Visual Field Defects
Eye problems from Lyme disease may appear mild and intermittent at first, such as a stinging in the eye, blurred vision, or even floaters or partial loss of the field of vision. An early sign of Multiple Sclerosis, particularly in younger women is partial vision-loss or other apparent neurological abnormality creating visual symptoms. Added to other overlapping symptoms between Lyme disease and MS it is easy to see why misdiagnosis so frequently occurs. WIth MS being an immune system disorder the treatment frequently involves suppression of the immune system with corticosteroids which, if the real cause of the visual symptoms is Lyme disease, would make the infection worse.
Natural Lyme Disease Therapies
Patients dealing with persistent symptoms of Lyme disease in their eyes may find it helpful to use natural anti-inflammatory treatment alongside their prescription medications (with their physicians’ approval, of course). Quercetin, bromelain, and even antioxidant vitamins E and C may be helpful to strengthen the immune system, lower systemic inflammation, and go some way to reducing free radical damage to the eyes. Patients should be wary of driving when suffering from ocular symptoms of Lyme disease as this may be both unsafe and illegal.
Testing for Lyme Diseaase
Whenever vision problems arise it is important to consult an ophthalmologist who may then refer cases on to a neuro-ophthalmologist or to a general practitioner if deemed necessary. Asensio Sánchez, et al (2003), reported a case of a patient whose only early symptom of Lyme disease was diplopia (double vision), with the infection confirmed by ELISA and treatment with antibiotics successful in resolving the infection and symptoms. Other researchers have noted isolated uveitis in both adults and children with Lyme disease and it may be expected that there are many patients whose symptoms continue while the long list of differential diagnoses are considered.
Vision Problems in Children with Lyme Disease
Systemic symptoms are not always present alongside ocular manifestations of Lyme disease but researchers in France did observe a variety of such symptoms in cases reported in a Strasbourg hospital between 2000 and 2010. Six children were treated for Lyme disease during this period and their symptoms included Lyme arthritis, rash, and erythema migrans in all cases, along with severe knee arthritis in two patients. The eye problems related to Lyme disease varied with two children suffering from uveitis, two from abducens palsies, one with optical neuropathy, and one with orbital myositis. Sauer, et al (2012), noted that any unexplained ocular symptoms, even in children, should prompt serological testing for Lyme borreliosis, especially in endemic areas. All of the patients were successfully treated with oral antibiotics and symptoms resolved within two to twelve weeks.
Permanent Eye Damage from Lyme Disease
Not all cases of ocular Lyme disease are so completely resolved, however. German researchers, Burkhard et al (2001), reported on the case of a fifty-eight year old woman who began experiencing symptoms within six weeks of a tick bite. The infection led to permanent visual field defects due to ischaemic lesions of the optic disc despite eventual antibiotic treatment that resolved the Lyme borreliosis. A letter to the British Medical Journal, published this month, noted that a self-limited follicular conjunctivitis is the most common visual symptom of Lyme disease, occurring in around 10% of cases. The letter also stated that some 4.3% of all cases of uveitis can be blamed on Lyme disease and that physicians should be suspicious of the involvement of Lyme borreliosis in cases where patients present with eye pain, redness, photophobia, or reduced visual acuity.
Improving Awareness of Lyme Disease Eye Problems
Even as early as 1991, a researcher in Florida published a paper calling for physicians to ask questions about patients’ exposure to tick endemic areas, recent skin rashes, and other Lyme disease symptoms when presenting with chronic iritis with posterior synechiae, vitritis in one or both eyes, an atypical pars planitis-like syndrome, big blind spot syndrome, and swollen or hyperemic optic discs. Smith, the paper’s author, discussed proper action to obtain a Lyme disease diagnosis and the need for further research into the ocular manifestations of Lyme disease at this time.
Many physicians remain unaware of the potential for Lyme disease infection to cause vision problems, especially in states where borreliosis is still considered rare or non-existent. Patients must, therefore, educate themselves on the potential ocular symptoms of Lyme disease so that blurred vision, double vision, swollen eyes, visual field loss, and other eye problems are not left to worsen without treatment.
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