Quick answer
Lyme disease affects the eyes only occasionally. Early on, some people get red, irritated eyes (conjunctivitis) along with flu-like symptoms. Later, rarer problems include double vision, inflammation inside the eye and eye dryness from facial palsy. A Lyme rash can also appear on the face near the eyes, since it can show up anywhere.
- CDC lists “visual disturbances” among the symptoms of neurologic Lyme disease.
- When facial palsy stops an eye from closing fully, CDC notes that eye drops or an eye patch may be needed to prevent dryness.
- CDC says the erythema migrans rash can appear anywhere on the body.
- MedlinePlus lists vision problems among the possible complications of untreated, later-stage Lyme disease.
How Lyme disease can affect the eyes
Eye involvement is uncommon, and most of what we know comes from case series and individual reports rather than large studies. A 2009 review of eye findings in Lyme disease (Mora and Carta, International Journal of Medical Sciences, based mainly on European cases) describes these patterns:
| When | What can happen | How common |
|---|---|---|
| Early (weeks after the bite) | Conjunctivitis: red, irritated eyes, in one or both eyes, often clearing on its own | About 7 to 11 percent of patients with the flu-like early illness, in the studies reviewed |
| When nerves are involved | Double vision or blurred vision, sometimes with inflammation of the optic nerve, usually alongside other nerve problems such as facial palsy | Uncommon |
| Later stages | Inflammation of the cornea (keratitis) or inside the eye (uveitis); scleritis is very rare | Rare |
Dry eye from facial palsy is one of the more practical eye concerns in Lyme disease. If you cannot close your eye fully, its surface can dry out and become irritated. Read more on our Lyme disease and the face page.
Lyme rash around the eyes
The erythema migrans rash starts where the tick bit, so if a tick attached near the hairline, eyebrow or eyelid, the rash can appear on the face near the eye. CDC describes it as a red patch that slowly expands over several days, can become large, often feels warm, and is rarely itchy or painful.
A red or puffy area around the eye has many other possible causes, including allergies, insect bites, styes and skin infections. A small bump that appears right after a bite and fades within a day or two is usually just a reaction to the bite, not Lyme. Compare examples in our Lyme rash guide.
Children and eye checks
Children may not mention blurry vision or eye discomfort. The 2009 review authors did not recommend routine eye exams for adults with Lyme disease but suggested considering eye screening for children, because they may not report symptoms. Ask your child’s provider whether an eye exam makes sense. See our guide to Lyme disease in children.
Diagnosis and treatment
Because many conditions affect the eyes, doctors look at the whole picture: time spent in Lyme areas, a tick bite or earlier rash, other symptoms, and blood tests. An eye specialist may be involved for inflammation inside the eye. Treatment centers on antibiotics for the Lyme infection itself, as described in our treatment guide, sometimes alongside eye-specific care.
We are collecting real experiences about eye symptoms during Lyme disease from people who have lived it, shared with their permission. As stories come in, they will appear here, clearly marked as personal experience rather than medical advice.
Call 911 for sudden trouble seeing combined with face drooping, weakness, trouble speaking or loss of balance, which can be signs of a stroke.
See a provider promptly, ideally the same day, for eye pain, sudden blurred or double vision, sensitivity to light with a severe headache, or a red, swollen eyelid with fever.
Frequently asked questions
Can Lyme disease cause eye problems?
Yes, but it is uncommon. Early Lyme can cause conjunctivitis. Rarer later problems include double vision, optic nerve inflammation, keratitis and uveitis. Dry eye from facial palsy is another cause of eye trouble.
Can the Lyme rash appear around the eyes?
Yes. CDC says the rash can appear anywhere, so a tick bite near the eye can lead to a rash there. Many other conditions can also cause redness around the eye.
Does Lyme disease cause blurry vision?
CDC lists visual disturbances among neurologic Lyme symptoms. Sudden blurry or double vision should be checked promptly, and with other stroke signs it is an emergency.
Are Lyme eye problems permanent?
The evidence is limited. In the review authors’ own case, vision fully recovered with treatment, but some inflammation of the cornea can persist after antibiotics and may need eye-specific care.