Lyme disease associated with unilateral interstitial keratitis

Purpose. To report a case of Lyme disease that presented with a single numm ular unilateral interstitial keratitis. Methods, Case report and review of the literature. Results. A 57-year-old black man who had contact with fresh ly killed deer had a chief complaint of foreign-body sensation in his right eye (OD) that had been diagnosed and treated for herpes simplex stromal ke ratitis. The patient underwent a systemic workup for interstitial keratitis . All results including RPR and MHA-TP were negative except for Lyme antibo dy titer (enzyme-linked immunosorbent assay [ELISA]) 178 U/ml (normal, <159 U/ml). Conclusion. Interstitial keratitis from Lyme disease has been regar ded as a bilateral disease in the literature. We present this infrequent oc ular manifestation of Lyme disease as a rare single nummular unilateral pre sentation.