Neuroretinitis as a Manifestation of Lyme Disease in South India: A Case Report

Materials and Methods: Retrospective case report. A 45-year-old lady who hails from the Nagarhole forest in South India presented with a history of tick bite followed by diminution of vision in the left eye. Fundus evaluation of the left eye showed neuroretinitis. Mantoux test, Treponema pallidum hemagglutination test, serum angiotensin converting enzyme, and ELISA for toxoplasmosis and rickettsial infections were negative. ELISA for Lyme disease was positive for IgM antibodies. This was confirmed by Western blot test. Results: Ocular inflammation resolved with a course of doxycyline and oral steroids. The species of the tick was also identified. Conclusion: This case highlights the need to consider Lyme disease, though rare in India, in the differential diagnosis of neuroretinitis especially if the patient hails from a forest area.