Think Outside the Lyme Box: Optic Neuropathy and Polyarthritis Caused by Borrelia miyamotoi

Borrelia miyamotoi disease (BMD) is an emerging tick-borne infection that can cause a range of symptoms. While typically presenting as an acute febrile illness, less common but significant complications, such as optic neuropathy, can occur. We describe a 68-year-old man who presented with high fever, rash, acute vision loss in the left eye, and polyarthralgia following a tick bite. Investigations confirmed BMD with associated optic neuropathy and polyarthritis. This case highlights the importance of considering BMD in patients with compatible symptoms and tick exposure and underscores the potential for severe ophthalmological and joint involvement.