Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. In its early stages, Lyme disease commonly results in a rash, which can appear anywhere from one day to one month after a tick bite, joint pain and headaches. Later-stage Lyme disease is characterized by arthritic pain, cognitive difficulties, fatigue and other symptoms that can have an enormous effect on a patient’s life.

One tick may carry more than one disease, so sometimes people get more than one co-infection from the bite of a single tick. Experienced doctors may be able to distinguish each of the tick-borne co-infections and order appropriate tests and treatment.¹ If left untreated, infection can spread to joints, the heart, and the nervous system. (See below for resources to learn more about Lyme Disease)

The Centers for Disease Control estimates that more than 300,000 new cases of Lyme disease occur each year in the U.S. However, some experts suggest this number may be under-estimated.

“The CDC only acknowledges positive tests for Lyme Disease,” says NORA co-founder William V. Padula, OD, SFNAP, FAAO, FNOR. “A blood test may be negative but the patient will have many symptoms, including visual processing dysfunction that can affect function, performance, cognitive and balance related activity. If not properly diagnosed and treated the infection, over months and years, becomes neurological and can’t be cured. This is where a Neuro-Optometric Rehabilitation Optometrist can play a critical role in early diagnosis and treatment.”

How does Lyme Disease Affect Vision?

In the early stages, visual symptoms can include: blur, visual fatigue, double vision, headaches associated with visual activities, losing place when reading, seeing words appear to double or become double when reading, and more obscure problems often not associated with vision such as difficulty with balance, spatial orientation, memory, comprehension, feeling of being over-whelmed by being in a busy-crowded environment with movement of people and objects, sensitivity to sound, to name several.²

In later stages of the disease, inflammation of the eye may develop. Parts of the eye that may be affected include the uvea, the middle layer inside the eye, the cornea, part of the outer coat of the eye; the iris, the colored circle around the pupil, and the choroid, a layer of blood vessels in the eye. Ocular symptoms can include sensitivity to light and floaters (spots in front of the eyes).³

Research also shows that when the visual process is compromised by tick-borne disease the person will develop compensatory habits in order to attempt to function with their compromised vision. This can put strain on the body that will lead to fatigue, discomfort and compromise of higher visual-perceptual processing associated with memory and cognitive function.

Treatment

Medical treatment for the Lyme or tick-borne disease does not always resolve the visual problems and without treatment the visual process will remain compromised even following completion of medical treatment. A Neuro-Optometric Rehabilitation Optometrist may use lenses, prisms and in some cases, Neuro-Visual Postural Therapy™, a rehabilitative intervention for persons who have had a neurological event affecting vision and its function/process.

This is particularly true for children. “Tick-borne disease will interrupt the critical cycles of development causing not only visual symptoms but also the possibility of developmental delays and interference in learning,” says Dr. Padula. “It is important to provide an in-depth visual evaluation by a Neuro Optometric Rehabilitation Optometrist not only of eyesight but of visual processing as well as visual intervention to re-establish balance in visual processing as soon as possible to avoid compensatory behaviors and interference with child development.”²

To learn more about Lyme Disease signs and symptoms, diagnosis, and testing, and treatments, here are some resources you can visit for more information:

• International Lyme and Associated Disease Society
• Centers for Disease Control and Prevention – Lyme Disease
• Lyme Disease Association
• Mayo Clinic – Lyme Disease
• Global Lyme Alliance

Dr. Padula and other leading experts will discuss a multidisciplinary approach and provide case studies regarding the management and rehabilitation of patients diagnosed with Lyme disease at the NORA Clinical Skills Pre-Conference (September 20-21) at the Hyatt Regency in St. Louis, MO. Click here for more information.

References

1. Lyme Awareness of Cape Cod, “Lyme Disease Co-Infections,” Accessed July 13, 2018
2. Padula Institute of Visual Rehabilitation, “Lyme and Tick-borne Disease: Compromise of Visual Processing”, Accessed July 11, 2018
3. The University of Illinois College of Medicine, “Lyme Disease and the Eye,” Accessed July 11, 2018