Summer is coming, and so are the ticks! I found this nasty little one on my 6-year-old son’s lower eyelid recently. It made me think of writing this article, with five facts about how tick bites can impact the eye.
- The infection that might come from a tick bite is from the spirochete microorganism Borrrelia burgdoreferi, which is about 20-30 microns long and 0,3 microns wide. This germ can cause Lyme disease.
- Without proper treatment, the patient is at risk of developing severe symptoms for the months and years to come. Treatment starts by immediately removing the insect and prescribing antibiotics based on lab testing or clinical evaluation. Antibiotics aren’t automatically prescribed as a preventative action.
- After the incubation time of two to three days, the first typical sign of Lyme disease is a rash that develops into a ring of redness in the periphery and paleness towards the central area. This isn’t that easy to spot if it’s in a place on the body with uneven anatomy – like at the eyelids. About 20% of patients don’t develop this sign. About 10% develop follicular conjunctivitis at this stage. Treatment with antibiotics needs to start if this occurs.
- If untreated with antibiotics, further symptoms can be flu-like, including headache and several neurological symptoms. Some of these may seem like those of covid-19, so lab testing is key here. Other symptoms can be inflammatory. The ocular findings at this stage can be uveitis, as a sign of generalised inflammation in the body. We may also see various retinal vascular inflammations, where also the heart is affected. Ocular manifestations can be retinal detachment due to inflammation.
- The end-stage of Lyme disease can be severe arthritis in big joints for months – again, if it doesn’t get treated. Keratitis can be seen at this stage, because of inflammatory reasons and not as a direct reaction from the germ itself.
It feels like a weird thing to say after writing about ticks and Lyme disease, but enjoy your summer – and be ready with your forceps!