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The ocular manifestations of Lyme disease.

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Lyme disease (with its ocular manifestations) is a worldwide disorder that is rapidly increasing in frequency. It is a treatable, multisystemic
disease that presents in three stages of severity. It can present with unusual forms of conjunctivitis, keratitis, cranial nerve palsies, optic nerve
disease, uveitis, vitritis, and other forms of posterior segment inflammatory
disease. A patient with any of these ocular manifestations should be questioned for exposure to an area endemic for
Lyme disease, tick bites, skin rash, or arthritis. Such patients should undergo serological testing. If the clinical presentation is suggestive of
Lyme disease, a course of oral antibiotics should be used (unless the patient gives a history of adequate therapy). Topical corticosteroids can be used for anterior segment inflammation. An antibiotic therapeutic trial can be used for posterior segment or neuroophthalmic
disease. Systemic corticosteroids without concomitant antibiotics should not be used in the treatment of ocular
Lyme disease. If ocular
Lyme disease is discovered and treated early, response to therapy is usually satisfactory.

Int Ophthalmol Clin. 1993 Winter;33(1):9-22. Review

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