Visual impairments are a prominent feature of a Lyme patient’s clinical presentation. Patients may complain of disturbance of visual acuity, blurry vision, floaters, pain on eye movement, frequent localized infections, and trouble keeping focus on a page when reading just to name a few.
My colleagues and I had the pleasure of presenting on this topic at the 2018 annual NORA – Neuro Optometric Rehabilitation Association conference this month in St. Louis, MO.
Dr. Thomas Moorcroft talked about the impact tick borne diseases such as Lyme and co-infections including Babesia and Bartonella have on our vision. Dr. Judy Leventhal delved into how a patient’s visual perception of their world can be disrupted in the setting of Lyme disease which can severely impact academics as well as work flow. Dr. William Padula showed his research done in his behavioral optometry practice on some diagnostic tools such as Angiogram and Visual Evoked Response (VER) which can be used in diagnosing Lyme patients. I focused on discussing typical and atypical neurological patient that presents with visual disturbances in the setting of Lyme disease and co-infections.
Visual floaters caused by ophthalmic artery vasculitis.
Opsoclonus Myoclonus Syndrome (OMS) - dancing eyes, causing impaired reading skills and dizziness.
Optic neuritis – inflammation of the optic nerve causing blurry vision and worsening visual acuity.
Saccadic intrusions on smooth pursuit and conversion insufficiency – abnormal eye movements, causing difficulty tracking when reading. This is one of the most common visual disturbances I see in my practice and can be very disturbing for the patient. It can be detected during a thorough neurological exam in the office. However, I find that it is frequently missed in clinical practice.
Uveitis – frequent eye infections that are a result of an impaired immune system caused by tick borne disease in the setting of Lyme disease and co-infections.
Your eyes are an extension of your brain. Its important to note and share changes (even if they are small) in your vision with your physician. Get proper testing and seek a specialist who is familiar and comfortable addressing and treating visual impairments.
In good health,
ELENA FRID, M.D. ABPN, ABCN
ADULT AND PEDIATRIC LYME EXPERT
BOARD CERTIFIED NEUROLOGIST & CLINICAL NEUROPHYSIOLOGIST
151 E 62nd, STE 1A New York, NY 10065 | T: 212-288-8832
Dr. Frid is a physician specializing in Lyme disease and sees patients with this condition - which is not universal among physicians. For more information about Lyme disease contact Dr. Frid follow Dr. Frid on Instagram @drelenafrid.
Tick season is the season when you and your pets spend time outdoors. Get your insect repellent kids wear and bug spray TODAY.
We want every child to have PROTECTION and SAFETY while enjoying the OUTDOORS.
Dr. Frid together with Dr. Charles Ray Jones, pediatric Lyme specialist, are working on NeuroLyme research. If you would like to contribute financially to this important research please contact the office.
Dr. Frid is hosting a second annual RWJMS Alumni Association fund raising event November 8th – which helps to raise money for qualified medical students to reduce the burden of high tuition.
Dr. Frid is taking over the role of RWJMS Alumni Association president January 2019.
October 11th, NYC - Global Lyme Alliance Gala. For tickets and info, click here.
November 5th, NYC - Project Lyme Gala.
For tickets and info, click here
Circa 400 BC, Hippocrates made the first postulate regarding the origin of all human emotion and declared, "Men ought to know that from the brain, and from the brain only, arise our pleasures, joy, laughter and jests, as well as our sorrows, pains, griefs, and tears."
(Neurology Vol 91, Number 12, Sept 18, 2018 - Contribution Dr. Topiwala: manuscript)
REFLECTIONS: NEUROLOGY AND THE HUMANITIES
by Christina Shenvi, MD, PhD
I’m feeling much older with every day.
More tired, more muddled, life wisping away.
And lately I’ve noticed I’ve been having more trouble,
Remembering words like “hairbrush” or “bubble.”
Words seem immeasurably harder to find.
Right when I need them, they’ve slipped my mind!
There’s one right now I’ve been rooting out,
But it keeps on jumping and slipping about.
The harder I try, the faster it moves.
Now it’s hiding in one of my postcentral grooves.
Could I have left it in the wrong frontal gyrus?
Did it slip down a sulcus and into a sinus?
Listen to the entire poem
Neurology® 2018;91:568-569. doi:10.1212/01.wnl.0000544323.09014.c0
VIDEO OF THE MONTH
COPYRIGHT © ELENA FRID MD PC 2018
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