Ocular Manifestations- Lyme

"Ocular manifestations of Lyme disease may occur at any stage but are more common in the last two stages.17

The most common ocular finding in stage I is conjunctivitis.19 During the second and third stages, ocular involvement includes anterior, intermediate, and posterior uveitis, endophthalmitis, keratitis (stromal opacities, punctuate superficial keratitis or peripheral ulcerative keratitis), and conjunctivitis.

Neuroophthalmic features can also occur, including involvement of third, sixth, and seventh cranial nerves (Bell's palsy, most common),21 optic nerve (optic neuritis and perineuritis, papilledema, ischemic optic neuropathy, optic nerve atrophy).

Other possible ocular involvement includes retinal hemorrhages, exudative retinal detachments, cystoid macular edema,20 blepharitis, scleritis and episcleritis.17,21 The most commonly reported ocular syndromes in stage II are conjunctivitis and uveitis.21 Bilateral interstitial keratitis has been described as a characteristic feature in the late stage of Lyme diseses.22-26"

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