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Ocular manifestations in
Lyme disease have been considered rare. In surveys and epidemiologic studies the possibility of ocular
Lyme disease has usually not been taken into account. Patients with late ocular.
Lyme disease may be seronegative by routine enzyme-linked immunosorbent assays, but immunoblot or detection of Borrelia DNA by polymerase chain reaction may help in diagnosing those cases. An ophthalmologist may suspect the diagnosis of
Lyme disease in inflammatory ocular syndromes with unusual biomicroscopic or angiographic findings. Intraocular
Lyme disease is usually treated with intravenous ceftriaxone or cefotaxime. Jarisch-Herxheimer reaction may occasionally complicate the antibiotic treatment of ocular manifestations. Overtreatment with ceftriaxone should be avoided because of a possibility of biliary complications.