Yearly Occurrence and Seasonality of Neuro-ophthalmic Manifestations of Pediatric Lyme Disease

Purpose: To review the neuro-ophthalmic manifesta-tions of Lyme disease at a central Ohio pediatric tertiary care center. Methods: A retrospective chart review of patients di-agnosed as having Lyme disease from September 2015 to September 2020 was completed. Demographic in-formation, diagnosis dates, and manifestations of Lyme disease were recorded. Patients were excluded for age older than 18 years or lack of corroborated Lyme dis-ease diagnosis. Descriptive statistics were performed. Results: Of the 212 cases of pediatric Lyme disease reviewed, 50 patients had neuroborreliosis. The data showed an increase in Lyme disease and neuroborrelio-sis cases from 2018 to 2020, with a preponderance of diagnoses in the summer months. Twenty-four patients had meningitis, and 6 of these patients (25%) were di-agnosed as having bilateral optic disc edema that was clinically consistent with intracranial hypertension. Conclusions: Papilledema in the setting of Lyme men-ingitis may be more common than previously reported in central Ohio. If Lyme disease meningitis is suspected, an opening pressure should be recorded at the time of lumbar puncture and, if elevated, an ophthalmologic evaluation for nerve edema is indicated.