Ocular manifestations and treatment of Lyme disease.

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.