Ocular manifestations of tick-borne diseases

Tick-borne illnesses are a significant disease burden worldwide. Diagnosis is challenging and requires a high level of clinical suspicion. Ocular manifestations reported in association with tick-borne disease are mostly as case reports and small case series because of the relative infrequency with which they occur; however, given the global nature of health care and increase in travel in the 21st century, it is important for ophthalmologists to be aware of ocular manifestations of these diseases because early diagnosis may reduce morbidity and mortality. Here, we review of the literature of tick-borne diseases with reported ophthalmic findings. All known human tick-borne diseases are discussed, including a brief description of the causative agent, region of endemicity, vector, systemic symptoms, and any reported eye findings. When possible, we also address the strength of the evidence for these ocular associations.