http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

Eye. 2007 Jan 19; [Epub ahead of print]

Papillitis, Lyme disease, and cats.

* Mishra SK,
* Murjaneh S,
* Morgan MS,
* Simcock PR,
* Glover S.


Correspondence: PR Simcock, West of England
Eye Unit, Royal Devon and Exeter Hospital
(Wonford), Barrack Road, Exeter EX2 5DW, UK
Tel: + 44 139 240 6008;
Fax: + 44 139 240 6022.
E-mail: psimcock@hotmail.com




Sir
Papillitis, Lyme disease and cats

We present a case of papillitis caused by Lyme disease in the UK. We
also highlight the increased risk of Lyme disease in cat owners.


Case report

A 50-yr-old man presented with a 10 day history of central blurring of
vision in his left eye. He had noted a rash on his right forearm 6
months previously. There was no definite history of a tick bite or of
visiting high-risk areas, but his cat had ticks. Unaided vision was
6/6-3 right and 6/4 left improving to 6/12 with pin hole. There was a
mild left relative afferent pupillary defect, a paracentral scotoma
inferior fixation, and mild impairment of colour vision, and a pink
swollen optic disc on this side.

Lyme disease antibody titres were +ve for ELISA and Western blot
methods, confirmed by a reference lab. The following investigations were
normal or negative: FBC, ESR, Auto-antibody screen, coagulation screen,
angiotensin converting enzyme anticoagulant. The patient was treated
with a 2 week course of IV ceftriaxone. The visual acuity however did
not change with treatment.


Comment

Lyme disease can mimic many ophthalmic conditions. It has been reported
to cause eyelid oedema, conjunctivitis, keratitis, episcleritis,
anterior uveitis, vitritis, choroiditis, endophthalmitis,
neuroretinitis, exudative retinal detachment, retinal vasculitis, optic
neuritis, optic atrophy, pseudomotor cerebri, paresis of cranial nerves
and orbital myositis. Optic neuritis in Lyme disease may or may not
respond to treatment with antibiotics.

In the mid-1970s, Dr Allen Steere and colleagues noted that a
significant number of patients with Lyme disease had cats and had noted
ticks on their pets, compared with their unaffected neighbours. Lyme
disease is now known to occur in cats, and Borrelia burgdorferi has been
isolated from the tissue of adult and nymphal ticks removed from
domestic cats. The increased risk of Lyme disease in cat owners is not
widely known. This case report may represent Lyme disease causing
papillitis transmitted from the patient's cat.


References

Sorry I'm not copy typing out the references too! but if anyone would
like the entire article in pdf just email me back.

best wishes

Gill