Background-Lyme arthritis is the most frequent late manifestation of Lyme b
orreliosis and has been associated with ocular inflammation.
Methods-A group of 153 children and adolescents with arthritis, 84 of whom
had Lyme arthritis and 69 other causes of arthritis, were followed prospect
ively for 22-73 (median 44) months in the course of a national study.
Results-Three of 84 patients with Lyme arthritis had ocular inflammation (4
%), including keratitis, anterior uveitis, and uveitis intermedia. All thre
e had symptoms of decreased visual acuity. Whereas anterior uveitis disappe
ared without sequelae, a corneal scar and a permanent loss of visual acuity
in the patients with keratitis and intermediate uveitis remained. Systemat
ic examination of all patients revealed no further ocular involvement. Of 6
9 patients with other causes of arthritis who were followed in parallel as
a control group, four of 15 patients with early onset pauciarticular juveni
le rheumatoid arthritis had chronic anterior uveitis and two of 12 patients
with juvenile spondyloarthropathy had acute anterior uveitis.
Conclusions-Ocular involvement with keratitis, anterior uveitis, and interm
ediate uveitis may occur in children and adolescents with Lyme arthritis. V
isual loss appears to be symptomatic, making regular ocular screening of su
ch patients unnecessary.