April 2010
Volume 51, Issue 13
ARVO Annual Meeting Abstract  |   April 2010
Neurologic Findings Following the Cutaneous Erythema Migrans of Early Lyme Disease: A Five Year Prospective Report
Author Affiliations & Notes
  • D. H. K. Jokl
    Ophthalmology,, New York Medical College, Columbia University, New York, New York
  • Footnotes
    Commercial Relationships  D.H.K. Jokl, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 1459. doi:
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      D. H. K. Jokl; Neurologic Findings Following the Cutaneous Erythema Migrans of Early Lyme Disease: A Five Year Prospective Report. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1459.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To determine whether patients, all presenting with the erythema migrans (EM) of acute Lyme disease and prior to demonstrating a positive Lyme blood titer would, when followed prospectively for five years, show neurologic or ocular findings.

Methods: : Within a week following a prescribed course of antibiotics, 12 patients had a complete ophthalmic evaluation which was repeated after one and five years.

Results: : Initially, 4/12 (33%) had a transient unilateral facial (VII) nerve paresis with onset 6 days - 2 months following the appearance of the EM and lasting 7 weeks.No further abnormal ocular findings were noted. 7/12 (58%) patients were evaluated up to 5 years from the acute EM onset and none showed ocular abnormalities or sequelae from prior VII nerve paresis. 1/7 (14%) presented with a hypertropia, initially thought due to myesthenia gravis, which proved to be non-progressive.

Conclusions: : Immediate antibiotic treatment for acute ( presenting with an EM) Lyme disease had no neurologic or ophthalmic sequelae after 5 years. A transient unilateral facial nerve paresis without late sequelae was seen in 1/3 of treated patients up to 2 months post EM onset.

Keywords: inflammation • neuro-ophthalmology: diagnosis 

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