Archive for the ‘Eye Issues’ Category

Optic Neuritis Associated With Lyme Disease

Optic neuritis associated with Lyme disease


In their article, “Characteristics of Lyme optic neuritis: a case report of Lyme associated bilateral optic neuritis and systematic review of the literature,” Lu et al. present a rare case of isolated bilateral optic neuritis in a Lyme disease patient. [1] (Optic neuritis is an inflammation of the eye’s optic nerve.)

The case features a 48-year-old female with multiple sclerosis (MS) who presented to her primary care physician with a fever and sore throat.

Three weeks later, she returned complaining of photophobia, eye pressure sensation, blurry vision, pain with eye movements and central scotoma on the morning prior to her visit. (A scotoma is a blurry or blind spot in your visual field while the surrounding areas appear normal.)

An “MRI along with fundus exam confirmed the diagnosis of bilateral optic neuritis,” the authors write.

Two months prior to her visit, the woman had removed a tick from her leg but did not report any rashes.

Testing for Lyme disease was positive by Western blot.

The woman was hospitalized and treated with intravenous methylprednisolone (1g/day for 3 days) due to the degree of swelling, along with ceftriaxone (2 g/day for 25 days) for Lyme disease.

The “patient returned for follow up 1 week post hospitalization, reported visual symptoms abated and she was back to her previous baseline,” the authors write.

“Clinicians working in the endemic areas should consider Lyme borreliosis in patients presents with bilateral optic nerve head swelling, and painless progressive visual loss.”

In reviewing the literature, Lu and colleagues found 11 patient cases of optic neuritis and Lyme disease.

“In this review, we collected cases that have demonstrated strong evidence of causal relationship of Lyme borreliosis and optic neuritis in attempt to characterize the nature and clinical presentations of optic neuritis involved in Lyme borreliosis…,” the authors write.

The most common symptoms related to optic neuritis included blurry vision (11 cases), headache (7 cases), scotoma (3 cases) and painful ocular movement (3 cases).

“Additionally, there were 4 reported neurological symptoms – paresthesia (3 cases) and ataxia (1 case); 3 reported arthralgia; and 3 reported nonspecifc symptoms – fatigue, weakness, and myalgia,” the authors write.

Only 2 of the 11 patients reported having an erythema migrans (Bull’s-eye) rash, while the majority did not recall having a tick bite.

Moderate vision loss was reported in 8 of the patients.

According to the authors, “The patients all responded well with combination of corticosteroid and antibiotic therapy, or antibiotic therapy alone.”

As the authors point out, typically optic neuritis presents with acute, painful, and unilateral visual loss. However, in these Lyme disease patients, it presented with “bilateral optic nerve head swellings, and painless, moderate (better than 20/200) and progressive visual loss.”

Rehabilitating Your Lyme-Impaired Vision

TOUCHED BY LYME: Rehabilitating your Lyme-impaired vision

March 22, 2022

Dr. William V. Padula is a pioneer in the field of how Lyme and other tick-borne diseases can affect your vision. He’s worked with patients from all over the world. Many of them had no idea that Lyme and TBDs were at the root of their deteriorating eyesight.

Though treating the underlying infections is necessary, he says such treatment alone may not be enough to resolve vision problems. Instead, he finds that many patients need various kinds of visual rehabilitation, as well.

In a recent Zoom conversation, he explained to me that among other things, Lyme disease can cause spatial-visual processing dysfunction. This isn’t a defect of the eye itself. Rather, the issue is that the brain has trouble processing the signals the eyes send to it. It’s a neurological impairment.

Spatial-visual processing dysfunction can result in eyestrain, headaches, light sensitivity, and double vision. “Also, people who have a compromised spatial-visual process can have difficulty in crowded, moving environments,” he says.

As a result, people with this disorder may feel overwhelmed by seeing anything moving in their peripheral vision. Much like people who have suffered concussions, Dr. Padula says, many folks with Lyme find they must strictly avoid busy supermarkets and other congested places.


The spatial process links up to what’s called proprioception—how the brain senses when the body is in an upright position, says Dr. Padula. “A frequent complaint of patients with tick-borne infections is that they feel clumsy—they are bumping into tables and doorways. Some have balance problems or actually fall.

His visual rehabilitation techniques use special lenses and prisms to help the brain “reset” the way it processes information.

According to Dr. Padula, when Lyme and other tick-borne infections disrupt visual processing in children, serious learning disabilities can result. He says identifying and treating the problem as early as possible is essential.

He established the Padula Institute of Vision Rehabilitation in Guilford, Connecticut, about 20 years ago, because he knew of no other place that offered this kind of help for children and adults with these neurological challenges.

“We see people here not just with Lyme dysfunction and infection, but also concussion, traumatic brain injury, Parkinson’s, Friedreich’s ataxia—quite a variety of neurological conditions that affect the visual process.”

Dr. Padula says after they’ve worked with someone at the Institute, he and his staff try to find a practitioner in the patient’s own area to continue the treatment. He also lectures and consults internationally, trying to share his methods with other eye doctors throughout the world.

Floaters and dry eyes

I also asked Dr. Padula about something I hear Lyme patients complain about a lot—floaters and dry eyes. He said this often results from a change in tear film. We have three different layers of tear film in our eyes—water, oily, and mucus. When these protective layers are damaged, floaters and dry eye can result.

He finds that additive-free eye drops and supplementation with bioflavonoids, Vitamin C, zinc and magnesium can help.

In the following YouTube video, Dr. Padula and an associate explain more about how Lyme disease can affect your vision.

More videos and further information available at his website.

Dr. Padula has co-authored a book called Neuro-Visual Processing Rehabilitation, which gives details about his methods.

TOUCHED BY LYME is written by Dorothy Kupcha Leland,’s Vice-president and Director of Communications. She is co-author of When Your Child Has Lyme Disease: A Parent’s Survival Guide. Contact her at

For more:

How Lyme Disease Can Affect Your Vision

TOUCHED BY LYME: How Lyme disease can affect your vision

Aug. 4, 2021

Dr. William Padula is a noted expert on how Lyme and other tick-borne diseases can affect the eyes.

According to his website, the following can all be symptoms of tick-borne illness: blur, visual fatigue, double vision, headaches associated with visual activities, light sensitivity, 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 overwhelmed by being in a busy environment, and sensitivity to sound.

The website notes: “The cause of the visual symptoms is because the tick-borne disease affects visual processing in the brain.”

Recently, Dr. Padula has discovered two eye-related biomarkers for tick-borne infection. (A biomarker is something that can be found by examination or testing that indicates the presence of a particular disease or condition.)

In an article published by Healio, Dr. Padula reports:

“My colleagues and I have demonstrated that the presence of a hazy, white ring of peri-papillary ischemia around the optic nerve — especially in children or adults younger than 60 years who would not be expected to have ischemic changes — is associated with tick-borne infection. One way that spirochetes hide from the immune system is by building up protective biofilms. We believe that these biofilms clog the narrow capillary vessels just around the perimeter of the optic nerve, blocking blood flow.”

Dr. Padula recommends that optometrists and ophthalmologists who observe this condition in patients who also have convergence insufficiency or focusing should rule out the possibility of tick-borne infection.

In the same article, Dr. Padula also discusses something called the Visual Evoked Potential (VEP) test. He says that abnormal results on this test strongly indicate tick-borne disease.

As we in the Lyme community know well, it often takes a long time for people to get properly diagnosed with tick-borne infections. If eye doctors become alert to these biomarkers, that could speed up the process considerably.

Click here to read the article on Healio.

Click here to visit Dr. Padula’s website

TOUCHED BY LYME is written by Dorothy Kupcha Leland,’s Vice-president and Director of Communications. She is co-author of When Your Child Has Lyme Disease: A Parent’s Survival Guide. Contact her at


For more:

Did Untreated Bartonella Steal Her Eyesight? At 91, She Still Wonders

Did untreated Bartonella steal her eyesight? At 91, she still wonders.

Lyme Disease Can Impact Your Vision’s “Contrast Sensitivity”

By Lonnie Marcum

March 30, 2021

LYME SCI: Lyme disease can impact your vision’s “contrast sensitivity”