Dr. sapna sabnani

Dr.Neetu Kori, DR. ANJALI DADU, Dr.KALPANA CHOURASIYA

Abstract

Lyme borreliosis can cause variety of ocular manifestation.

CASE: 19 year female presented with sudden, painless, diminution of vision in both eye since 2 days. Ocular examination revealed OU visual acuity of PL positive with PR accurate. Both eye pupil were sluggishly reacting to light and rest anterior segment was normal. Fundus revealed bilateral optic disc pallor, pale white retina, box carting of vessels with cherry red spot & few superficial retinal hemorrhages. Systemic and neurological examination was within normal limit.

Diagnosis of both eye bilateral CRAO with suspected optic neuritis was made. Patient was evaluated for autoimmune, infectious & cardiovascular causes. MRI orbit showed bilateral optic nerve enhancement, imaging of brain and spine was normal. Serology was positive for lyme disease, with potential CNS involvement based on CSF immunoblot analysis.

Patient was treated with combination of systemic antibiotics & steroids, but there was no visual improvement.