Lyme Disease and the Eyes

Lyme and other tick-borne diseases can cause many ocular manifestations including double or blurry vision, floaters, conjunctivitis (pink eye), inflammation of several parts of the eye, sensitivity to light, dry eye, “static” in the visual field, and vision loss or a blind spot.

I was born with a condition called strabismus, more commonly known as “lazy eye.” To strengthen weak muscles and help my eyes align, I had four surgeries over the course my childhood and early twenties. The fourth was two years after I’d unknowingly contracted Lyme disease, babesiosis, ehrlichiosis, and possible bartonella from a tick bite.

Following that surgery, people started commenting, “Why are your eyes two different sizes?” My surgeon and I were both perplexed. Recovery was slower than it had been from previous operations, and my right eye appeared wide open while the left had a noticeable lid droop.

Had we known I had tick-borne infections, the sudden changes would have made more sense. In fact, my physical presentation could have been a tip-off to my physician to consider testing me for tick-borne diseases. Lyme disease loves to live in scar tissue, particularly, my Lyme Literate Medical Doctor (LLMD) later told me, in areas like the eyes. Having spirochetes hanging out in my ocular tissue likely contributed to the constant migraines I suffered that caused excruciating pain over my left eye. The droopy lid may have also been Bell’s Palsy, a common symptom of Lyme disease that causes weakness or paralysis on one side of the face.

While my issues all occurred on the outside of my eyes, Lyme and other tick-borne diseases can cause many ocular manifestations including double or blurry vision, floaters, conjunctivitis (pink eye), inflammation of several parts of the eye, sensitivity to light, dry eye, “static” in the visual field, and vision loss or a blind spot [i]. Those of us with neurological Lyme disease often have difficulty with bright, flashing lights; I need to look down (after pulling over!) when emergency vehicles go by, and I avoid concerts or places with strobe lighting as well as TV shows and movies that have a lot of fast action.

In their book Conquering Lyme Disease: Science Bridges the Great Divide, Brian Fallon, MD and Jennifer Sotsky, MD describe a case of an eight-year-old boy who had difficulty seeing the TV screen a couple months after visiting a Lyme-endemic area. A visual exam found severely decreased vision due to swollen optic nerves. Because the child also had headaches, fatigue, and intermittent pain, his doctor considered Lyme disease; sure enough, the boy tested positive. After treatment, his optic nerves and vision return to almost fully normal. [ii]

This child was lucky because his doctor considered Lyme disease as an underlying cause of an acute medical condition. If you are experiencing vision difficulties and have spent time in a Lyme-endemic area, you may want to talk to your doctor about Lyme and other tick-borne illnesses. If you are already a Lyme disease patient, it’s important to tell your LLMD about any ocular issues you may be having, as your doctor may want to change your treatment plan based on these symptoms. Lyme disease can indeed affect the whole body!

Can Lyme Disease Affect Your Eyes?

As discussed above, yes. Although it may not be the most common or well-known symptom, there are several ways Lyme disease and other tick-borne illnesses can affect your eyes.

Lyme Disease Eye Symptoms

Eye problems from Lyme disease include:

• Optic Neuritis
• Conjunctivitis, or Pink Eye
• Retinal Vasculitis
• Light Sensitivity

What is Optic Neuritis?

Optic neuritis is the medical term for inflammation of the optic nerve. As one of the rare complications of Lyme disease, there is limited research on the connection of optic neuritis and Lyme disease. With this type of eye inflammation, several manifestations can occur, including:

• Vision Loss
• Blurred Vision
• Eye Pain

Other Lyme Disease Symptoms

From your nervous system to ocular involvement, untreated Lyme disease can strike many aspects of a body. Whether you are having common flu-like symptoms or showing signs of post-treatment Lyme disease syndrome, some of the most common symptoms of Lyme disease include:

• Bull's eye Rash (Erythema Migrans)
• Fatigue
• Swollen Lymph Nodes
• Joint Pain
• Lyme Arthritis
• Aches
• Bell's Palsy
• Neurological or Cognitive Features
• And More

Learn more about the stages and symptoms of Lyme disease.

Lyme Disease Diagnosis

Early diagnosis and treatment are crucial for a bacterial infection such as Lyme disease (bacterium borrelia burgdorferi). If you have had a possible infected tick bite, live in an endemic area, or are presenting symptoms, contact your healthcare provider for medical advice and possible laboratory tests.

Lyme Disease Prevention

Want to know how to avoid a deer tick? From insect repellent in wooded areas to wearing light-colored clothing, check out GLA's tips on Lyme prevention.

[i] Phillips, Steven, MD and Parish, Dana with Loberg, Kristen. Chronic: The Hidden Cause of the Autoimmune Pandemic and How to Get Healthy Again. Boston and New York: Houghton Mifflin Harcourt, 2020 (70-71).

[ii] Fallon, Brian A., MD and Sotsky, Jennifer, MD. Conquering Lyme Disease: Science Bridges the Great Divide. New York: Columbia University Press, 2018 (44).