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The eye and tick-borne disease in the United States

Sathiamoorthi, Saraniya; Smith, Wendy M.

Current Opinion in Ophthalmology: November 2016 - Volume 27 - Issue 6 - p 530–537
doi: 10.1097/ICU.0000000000000308
OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read

Purpose of review Tick-borne diseases are increasing in incidence and geographic distribution. Several diseases endemic to the United States have ophthalmic manifestations, including the most common tick-borne disease, Lyme borreliosis. As ocular complaints may lead a patient to seek medical evaluation, it is important to be aware of the systemic and ophthalmic manifestations of tick-borne diseases in order to make the correct diagnosis.

Recent findings Vision-threatening ophthalmic manifestations are relatively common in Lyme disease and Rocky Mountain spotted fever. Ocular involvement is rare in babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever.

There are clear guidelines for diagnosis and treatment of Lyme disease; however, confusion and misinformation among the general public as well as controversy about chronic or late-stage Lyme disease can impact the evaluation of ophthalmic disease. Furthermore, there are many gaps in our knowledge regarding the pathophysiology of ocular borreliosis although it seems likely that Lyme uveitis is rare in the United States.

Summary Knowledge of systemic and ophthalmic manifestations combined with an understanding of the epidemiology of disease vectors is crucial for the diagnosis of tick-borne diseases.

aMayo Medical School

bDepartment of Ophthalmology

cMayo Clinic, Rochester, Minnesota, USA

Correspondence to Wendy M. Smith, 200 First St. SW, Rochester, MN 55905, USA. Tel: +1 507 284 3726; e-mail: smith.wendy1@mayo.edu

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