How Lyme Disease and Co-Infections Affect the Eyes

Eye Symptoms

When Lyme disease or another tick-borne infection enters the visual system, it can lead to inflammation and impaired eye functioning. Some of the most common complaints include:

Optic neuritis or an inflamed optic nerve: Patients may experience sudden vision loss or blurring, pain with eye movement, or colors appearing less bright.

Retinal vasculitis: This is inflammation of the blood vessels in the retina, the light-sensitive tissue at the back of the eye, which can lead to vision loss if untreated.

Uveitis: The inflammation of the uvea, or middle layer of the eye, can result in redness, light sensitivity, blurry vision, pain, and floaters.

Convergence insufficiency: This condition occurs when the eyes have trouble working together to focus on nearby objects, often causing headaches, eye strain, or double vision.

Nystagmus: The eyes move rapidly or uncontrollably up and down, from side to side, or in circles, making it hard to focus clearly.

Ptosis: This describes a droopy upper eyelid, which can negatively affect appearance and obstruct vision.

Adie’s pupil or Argyll Robertson pupil: These neurological disorders affect the pupil and can result in symptoms like one pupil being bigger than another, a slow reaction to light, difficulty focusing, and blurred vision.

Follicular conjunctivitis: This form of eye inflammation shows up as small, round bumps on the inner eyelids.

Vitritis: This condition happens when the clear gel inside the eye becomes inflamed, which can make a person’s vision look cloudy or full of small, floating spots.

Posterior segment inflammatory disease: This involves inflammation in the back part of the eye, leading to redness, light sensitivity, blurred vision, floaters, and potentially vision loss (if left untreated).

Orbital myositis: This inflammation of the muscles around the eye can cause pain, swelling, and sometimes double vision or trouble moving the eye.

Ocular adnexa inflammation: This refers to swelling or irritation of the tissues and structures that support the eye, such as the eyelids, tear glands, and surrounding connective tissue.

Neuro-ophthalmological alterations: These are vision problems caused by damage or disease affecting the nerves or brain areas that control sight and eye movement.

Branch retinal vein occlusion (BRVO): This condition occurs when a small vein in the retina gets blocked, cutting off normal blood flow and causing blurred or distorted vision that can come on suddenly.

Chorioretinitis: This is inflammation in the back of the eye that affects both the retina and the layer of blood vessels beneath it, often leading to blurry vision, light sensitivity, or seeing dark spots.

Photophobia: This means being unusually sensitive to light, where even normal brightness can cause eye pain, headaches, or the need to squint or look away.

Keratitis: This inflammation of the cornea—the clear, front part of the eye—can cause pain, redness, blurred vision, and a gritty or burning feeling.

Opsoclonus-myoclonus syndrome (OMS): This is a neurological disorder that causes rapid, jerky eye movements, sudden muscle twitches, and problems with balance or coordination.

Strabismus: This is a condition in which the eyes don’t line up properly, causing them to point in different directions, which can lead to double vision or trouble focusing.

Internuclear ophthalmoplegia (INO): This is a disorder where damage to nerve pathways between the eyes prevents them from moving smoothly together, often causing double vision or jerky eye movements when looking side to side.

Myositis: When myositis affects the eyes, it causes inflammation of the eye muscles, leading to pain, swelling, and difficulty moving the eyes or keeping them aligned.

Episcleritis: This is a mild inflammation of the thin layer of tissue between the white of the eye and its clear outer coating, causing redness, tenderness, and occasional discomfort.

Anterior and posterior scleritis: These are painful inflammations of the white outer wall of the eye—either at the front (anterior) or deeper in the back (posterior)—that can cause severe eye pain, redness, and blurred vision.

Macular edema: This refers to when fluid builds up in the center of the retina—the macula—causing swelling that blurs or distorts central vision.

Endophthalmitis: This serious infection inside the eye causes redness, severe pain, and vision loss if not treated quickly.

Papillitis: This is inflammation of the optic nerve where it meets the eye, often causing sudden vision loss, eye pain, and blurred or dim sight.

Papilledema: This is swelling of the optic nerve caused by increased pressure inside the skull. It can lead to blurred vision, headaches, or brief episodes of vision loss.

Granulomatous keratic precipitates: These are clusters of inflammatory cells that stick to the back of the cornea. They often appear as greasy-looking spots during eye exams and signal chronic inflammation inside the eye.

If you have sudden changes in vision or other eye symptoms, please consult an ophthalmologist, and consider Lyme disease and other tick-borne infections as a potential cause, especially if you experience a wide range of symptoms that affect multiple body systems.