# Retrospective Case Series of Ocular Lyme Disease, 1988–2025

## TL;DR

This study reviews rare eye-related cases of Lyme disease from 1988 to 2025, highlighting common symptoms and the need for better diagnosis.

## Contribution

The study compiles and analyzes a rare retrospective case series of ocular Lyme disease over a long period.

## Key findings

- Uveitis was the most common ocular manifestation in 45% of cases.
- Microbiologic proof was found in only six cases across various ocular conditions.

## Abstract

Reports of ocular manifestations of Lyme disease (LD) are uncommon, and signs and symptoms may be overlooked by physicians. We conducted a retrospective case series of ocular LD reported during 1988–2025. Among 27 published reports in PubMed, we noted that, in 38 cases, the most common ocular manifestation was uveitis, representing 45% of cases, followed by optic neuritis and cranial nerve palsies (including trochlear and abducens). Not all cases met Centers for Disease Control and Prevention surveillance guidelines for LD, given that some case reports were published before the current guidelines. Cases that provided microbiologic proof were 2 anterior uveitis cases, 1 case of anterior uveitis with abducens’s nerve palsy, 1 case of intermediate uveitis, and 1 case of intranuclear ophthalmoplegia. Ocular LD can have a broad variety of manifestations; therefore, physicians should be aware of those manifestations and obtain microbiologic proof for a more definitive diagnosis and epidemiologic value when possible.