OCULAR MANIFESTATIONS OF LYME BORRELIOSIS: CURRENT STATE AND FUTURE PERSPECTIVES
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i3.15551Keywords:
Lyme borreliosis, Lyme disease, uveitis, keratitis, ophthalmologyAbstract
SUMMARY. The aim – to systematize current knowledge on ophthalmological complications of Lyme borreliosis, focusing on non-rheumatogenic forms, their prevalence, clinical manifestations, diagnostic methods, treatment approaches, preventive measures, and prospects for improving the diagnosis and therapy of ocular pathologies, particularly in endemic regions.
Material and Methods. A review of scientific literature was conducted, including epidemiological reports, clinical studies, laboratory and instrumental diagnostic methods, as well as strategies for the treatment and prevention of ocular complications in Lyme borreliosis. Data were sourced from PubMed, Scopus, Web of Science, and reports from the U.S. Centers for Disease Control and Prevention (CDC) and the Public Health Center of the Ministry of Health of Ukraine. Special attention was given to non-rheumatogenic forms associated with Borrelia garinii and their manifestations in Ukraine.
Results. Lyme borreliosis is the leading tick-borne infection in the Northern Hemisphere, with an annual incidence of 20–200 per 100,000 people in Europe and up to 476,000 cases in the USA. In Ukraine, an increase in cases has been noted, particularly in western regions. Ocular complications, such as conjunctivitis, uveitis, keratitis, and optic neuritis, are rare but more frequent in neuroborreliosis associated with B. garinii. Diagnosis is challenging due to the low sensitivity of serological tests and the non-specific nature of symptoms. Treatment involves antibiotics (ceftriaxone, doxycycline), steroids, and mydriatics, but chronicity and side effects, such as the Jarisch-Herxheimer reaction, complicate therapy. Prevention focuses on avoiding tick bites and early tick removal.
Conclusions. Ocular manifestations of Lyme borreliosis, particularly non-rheumatogenic forms, may impact vision, but their association with the disease requires further clinical investigation. Current diagnostic and therapeutic methods have limitations, highlighting the need for new tools, such as multiplex tests, and a multidisciplinary approach. For Ukraine, as an endemic region, key priorities include raising awareness among healthcare professionals and improving access to modern technologies for early detection and effective treatment.
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