Visual impairments are a prominent feature of a Lyme patient’s clinical presentation. Patients may complain of

• disturbance of visual acuity
• blurry vision, floaters
• pain on eye movement
• frequent localized infections
• trouble keeping focus on a page when reading just to name a few

My colleagues and I had the pleasure of presenting on this topic at the 2018 annual NORA – Neuro Optometric Rehabilitation Association conference this month in St. Louis, MO.

Dr. Thomas Moorcroft talked about the impact tick borne diseases such as Lyme and co-infections including Babesia and Bartonella have on our vision.

Dr. Judy Leventhal delved into how a patient’s visual perception of their world can be disrupted in the setting of Lyme disease which can severely impact academics as well as work flow.

Dr.William Padula showed his research done in his behavioral optometry practice on some diagnostic tools such as Angiogram and Visual Evoked Response (VER) which can be used in diagnosing Lyme patients. I focused on discussing typical and atypical neurological patient that presents with visual disturbances in the setting of Lyme disease and co-infections.

Cases included:

1. Visual floaters caused by ophthalmic artery vasculitis.

2. Opsoclonus Myoclonus Syndrome (OMS) – dancing eyes, causing impaired reading skills and dizziness.

3. Optic neuritis – inflammation of the optic nerve causing blurry vision and worsening visual acuity.

4. Saccadic intrusions on smooth pursuit and conversion insufficiency – abnormal eye movements, causing difficulty tracking when reading. This is one of the most common visual disturbances I see in my practice and can be very disturbing for the patient. It can be detected during a thorough neurological exam in the office. However, I find that it is frequently missed in clinical practice.

5. Uveitis – frequent eye infections that are a result of an impaired immune system caused by tick borne disease in the setting of Lyme disease and co-infections.

Your eyes are an extension of your brain. Its important to note and share changes (even if they are small) in your vision with your physician. Get proper testing and seek a specialist who is familiar and comfortable addressing and treating visual impairments.

In good health,

ELENA FRID, M.D. ABPN, ABCN

ADULT AND PEDIATRIC LYME EXPERT

BOARD CERTIFIED NEUROLOGIST & CLINICAL NEUROPHYSIOLOGIST

151 E 62nd, STE 1A New York, NY 10065   |   T: 212-288-8832

ELENAFRIDMD.COM   |   WWW.DRFRID.COM

Dr. Frid is a physician specializing in Lyme disease and sees patients with this condition – which is not universal among physicians. For more information about Lyme disease contact Dr. Frid follow Dr. Frid on Instagram @drelenafrid.