Orthoptic and Ophthalmologic Assistance Unit - Eye Clinic, Neuromusculoskeletal Department, Careggi Hospital, University of Florence, Italy.

Corresponding Author: Silvia Maddii, Orthoptic and Ophthalmologic Assistance Unit - Eye Clinic, Neuromusculoskeletal Department, Careggi Hospital, University of Florence, Italy, Tel: +390557947759; E-Mail: [email protected]

Received Date: 27 Dec 2017  
Accepted Date: 09 Jan 2018  
Published Date: 12 Jan 2018

Copyright © 2018 Maddii S

Citation: Maddii S. (2018). Diplopia as the Sole Symptom of Lyme Borreliosis. Mathews J Case Rep 3(1): 034.

ABSTRACT

Lyme Borreliosis (LB) is the most common human tick-borne disease in the Northern Hemisphere.
The illness usually begins with erythema migrans, followed by neurologic or cardiac abnormalities and finally arthritis. Ocular complications have been reported, including conjunctivitis, keratitis, uveitis, oculomotor palsies, papilloedema and others, but they have been rarely described in literature as unique clinical feature of disease.
Herein, the case of a 53-year-old Caucasian woman with diplopia as the sole symptom of LB. No other systemic symptoms were detected, leading to an initial misdiagnosis. 
Undergoing to detailed investigation, our patient actually had serology positive for Borreliosis. 
Two months after antibiotic and orthoptic treatment, diplopia definitively disappeared.
These results confirm the theory that an appropriate drug therapy associated with an effective orthoptic rehabilitation has made possible a quick restoration of binocular vision, achieving a good quality of life. 
This case demonstrates the importance of considering LB as part of the differential diagnosis of patients with isolated cranial nerve palsies, stressing the importance of the orthoptic intervention.

KEYWORDS

Abducens Nerve Palsy; Diplopia; Eye Movement Training; Lyme Borreliosis; Orthoptic Evaluation; Prism Rehabilitation.