Here is a nice synopsis by Lyme expert Dr. Daniel Cameron of an article in Current Opinion in Ophthalmology on the growing list of eye problems in Lyme Disease. Although many of us think of TBI as Traumatic Brain Injury, the other TBI to which I refer is Tick-Borne Infections, the umbrella under which Lyme is subsumed. I blogged about this a few years ago, and the following useful table summarizes some of the neuro-cognitive issues that we may encounter.
Bear in mind that many of the clinical presentations of Tick-Borne Infections can be very subtle, and for that reason we approach therapy from a very similar standpoint that we do the other TBI – more specifically mTBI, and the conceptual model introduced by Ciuffreda, Ludlam, and Nadav.
There can be a fine line in the continuum between pain and discomfort, but when patients have chronic, lingering discomfort in and around the eye, keep Lyme and the other TBIs in mind. When there is actual pain and/or swelling in the eye, and the usual suspects have been ruled out, think in particular about Idiopathic Orbital Myositis and the treatment algorithm for that condition.