I posted it on another LD forum and found somebody with the same symptom. Not sure if anyone here noticed different pupil size with other annoying eye problems which can't be diagnosed?
***********Original Message*********************
I began to notice that I have different pupil size since August 2006 and the optologist didn't see any problem with it. I got bit in April/May 2006, by the way. I'm sure my pupil size used to be the same since it's never documented in my previous eye exam records before that date...
I read that menigitis may cause different pupil size, and lyme can cause menigitis. I don't have fever, so no doctors think I could have menigitis. I had CAT done for my brain, and it came back OK. Will have MRI done and see what it is.
But I'm still curious, is anybody here bothered with different pupil size? Did you notice it after you got bit / lyme?
Thanks!
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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cactus
Frequent Contributor (1K+ posts)
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posted
My pupils have often been different sizes - dramatically enough that other people frequently notice and comment.
This began after I had Lyme, but long before I was diagnosed. It did not seem to be related to any type of medication.
It seems to have lessened with abx treatment.
As for halos and double vision - I've had both of those as well - but for the most part attributed it to my ever-changing contact/glasses prescriptions.
Ketek also caused increased double vision for me, but that resolved back to "normal" once I switched abx.
-------------------- �Did you ever stop to think, and forget to start again?� - A.A. Milne Posts: 1987 | From No. VA | Registered: May 2005
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I know as a fact a lot of lymies have vision problem (halo, double vision, floaters, and sensitivity to light).
If your changing pupil size is also caused by LD, I'd be more positive that LD would attribute to this as well!
Geez, the evil bug!
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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bejoy
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Member # 11129
posted
I get the raised eyebrow thing from docs of all kinds because my pupils are never "equal and reactive." They respond independently to light changes.
My halos come from all those wads fo floaty things camping out in my eyeballs.
-------------------- bejoy!
"Do not go where the path may lead; go instead where there is no path and leave a trail." -Ralph Waldo Emerson Posts: 1918 | From Alive and Well! | Registered: Feb 2007
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posted
My left pupil has become bigger than my right. My left eyebrow was creeping toward my hairline until I started doxy, then it crept back down. Kris
Posts: 520 | From Maryland | Registered: Jan 2007
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posted
We adopted a boy from Russia when he was 20 months and he's now 10. Since he lived in an orphanage there, and I saw it, I think it's unlikely that he got bitten by a tick there.
He does have very different pupils. One day he fell on the playground and the school nurse was worried that he might have a head injury because of the pupils ... but they're always like that.
The only health issue I know he had was Rickets from a Vitamin D deficiency (little light exposure).
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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posted
yeah I had that - I never noticed it but my doc did and sent me for tests which showed nothing.
Posts: 33 | From North Central PA | Registered: Jan 2007
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CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
I had that - it is called Adie pupil and is associated with Lyme in the lit-
1: Lancet. 2001 Mar 10;357(9258):805. Links Comment on: Lancet. 2000 Nov 18;356(9243):1760-1. Holmes-Adie syndrome and Lyme disease. Stricker RB, Winger EE.
The Lancet, Volume 357, Number 9258, 10 March 2001
Correspondence
Holmes-Adie syndrome and Lyme disease
Sir--Paolo Martinelli (Nov 18, p 1760 1 provides an excellent clinical and historical overview of Holmes-Adie syndrome (tonic pupil and areflexia), more commonly known in the USA as Adie syndrome. Although the syndrome has not been associated with "infection of conventional bacterial or viral origin", it is occasionally linked to early syphilis, parvovirus B19, and herpes simplex virus infections.2-4 We now report an association with neurological Lyme disease.
In a referral practice of about 140 patients with Lyme disease, we have seen three patients with predominant neurological symptoms who presented with Holmes-Adie syndrome (table). The diagnosis of Lyme disease was based on a history of tickbite, presence of an erythema migrans rash and positive serology for the spirochaete Borrelia burgdorferi. The duration of Lyme disease symptoms ranged from 2-16 years, and each patient developed a unilateral tonic pupil before the diagnosis of Lyme disease was made. All three patients had significant neuropsychiatric and cognitive defects, hyporeflexia, and facial dysaesthesia without anhydrosis. Rapid plasma reagin testing was negative in each case. Two patients had abnormal brain magnetic resonance imaging with white-matter lesions consistent with neurological Lyme disease. A decreased concentration of CD57 lymphocytes characteristic of chronic Lyme disease5 was found in two patients before antibiotic therapy. Of note, Holmes-Adie syndrome persisted in each case despite intravenous antibiotic therapy and partial resolution of other neurological symptoms of Lyme disease.
Patient Age/sex Duration Topic CD57 Brain Antibiotic of Lyme pupil (cells/�L) MRI treatment disease (years) ------- ------- -------- ---------- ---------- ----- ---------- 1 39 F 16 Unilateral 49* Negative IV 2 42 F 8 Unilateral 31* Positive IV 3 39 F 2 Unilateral 111† Positive IV
MRI=magnetic resonance imaging; IV=intravenous ceftriaxone. *Before antibiotics. †On antibiotics. Normal CD57 range 60-360 cells/�L. Characteristics of patients with Lyme disease and Holmes-Adie syndrome
Neurological Lyme disease has been associated with various cranial nerve, meningeal, and neuropsychiatric abnormalities.5 Based on our clinical observation, it seems that Holmes-Adie syndrome might represent an early and unrecognised manifestation of Lyme disease. We suggest that patients presenting with this unusual neuro-ophthalmological syndrome should be tested for the Lyme disease spirochaete.
*Raphael B Stricker, Edward E Winger
1 Martinelli P. Holmes-Adie syndrome. Lancet 2000; 356: 1760-61.
2 Yasaki S, Ohshima J, Yonekura J, TakahashY, Someya K. A case of early syphilis presenting general paresis-like symptoms and bilateral tonic pupils. Rinsho Shinkeigaku 1992; 32: 994-99.
3 Corridan PG, Laws DE, Morrell AJ, Murray PI. Tonic pupils and human parvovirus (B19) infection. J Clin Neuroophthalmol 1991; 11: 109-10. [PubMed]
4 Anzai T, Uematsu D, Takahashi K, Katayama T. Guillain-Barre syndrome with bilateral tonic pupils. Intern Med 1994; 33: 248-51. [PubMed]
5 Stricker RB, Winger EE. Decreased CD57 lymphocyte subset in patients with chronic Lyme disease. Immunol Lett (in press).
---
PMID: 11254002
1: Arq Bras Oftalmol. 2005 May-Jun;68(3):381-4. Epub 2005 Jul 26. Links Bilateral tonic pupil as the only remaining ophthalmic sign of Lyme disease: case report. Fugimoto F, Ghanem RC, Monteiro ML. Clinica Oftalmologica, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. [email protected]
Lyme disease is a multisystemic disorder caused by Borrelia burgdorferi spirochete, transmitted by ticks. Mainly described in the northern hemisphere and rarely in Brazil. The purpose of this report is to describe a patient with Lyme disease who developed bilateral tonic pupil as the only remaining sign. A 13-year-old female with Lyme disease, presented with bilateral peripheral facial and oculomotor paralysis. After recovery from neurological abnormalities the patient sustained anisocoria, reduced fotomotor reflex, less than normal amplitude of accommodation, tonic pupil constriction for near objects and slow redialation in both eyes. Dilute 0.1% pilocarpine test was positive in both eyes, confirming the suspicion of bilateral tonic pupil. This is the first case report of bilateral tonic pupil caused by Lyme disease.
PMID: 16059573
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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I'll print this and fax it to the MDs even though they won't be treating my LD (still not yet diagnosed in lab)!!!
You are awesome!!
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
Hey Justag*)!!
The following site addy is PubMed, which is the National LIbrary of Medicine Online- they try to get EVERY article from EVERY medical journal they can in there- it is my favorite resource- HOWEVER- there is a catch- it is indexed by keywords which are human designated- and sometimes quite whimsical- it is not a total word search but only keyword- so you can have a brand-new Lyme abstract for example, which is entered in there under "tick" or "ticks" or "neuroborreliosis" or "Lyme" OR all of those words OR NONE of those words but "spirochete" instead- or by the misdiagnosis- it is a very whimsical place, pubmed, I love its mystery*)! However, you can google scholar pubmed and get word search w/o keyword, but it takes a lot longer to weed through the dross-!!!
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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Marnie
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Member # 773
posted
Request a FUNCTIONAL MRI. They use a dye and track blood flow thru the brain vessels.
It will indicate if any vessels are too small or plaque filled.
This is a more accurate test.
Out of curiosity which pupil is the most dilated...left or right?
Is it on the same side for all of you?
Posts: 9424 | From Sunshine State | Registered: Mar 2001
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posted
CaliforniaLyme, thanks again! I'll use that online library as well, thanks for throwing it my way!!
Marnie, I got bit on my LEFT THIGH and I got many floaters in my RIGHT EYE which has the bigger pupil and light sensitivity.
I would have an MRI soon, but don't think I would get anything diagnosed there...
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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caat
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Member # 2321
posted
maybe you want a spect instead of an mri... ??
You can DEFINITELY have meningitis without showing much if any fever with lyme. I sure didn't show fever and I had meningitis! Lyme produces what is refered to as "aseptic meningitis" which is often misdiagnosed as viral meningitis. Lyme generally has a very low white blood cell count & low sed rate both in blood and spinal fluid. AND a low temperature. Often people will have a "base" temp of 92 - 96F or so and feel feverish at 98F. This can also be confused with viral infections- but it is a bacteria.
Do you feel a lot of head pressure? pressure headaches? Is your sense of space off- do you miss things you reach for? Or miss and knock them off the shelf if your not very careful? Is it hard to feel where your feet are in space? Do you stumble a lot? are you confused? Does your reading ability change back and forth? Do you have phantom itching and tingleing?
IF you think you have meningitis, unfortunately you will probably have to do the work for your doc unless you have an llmd. Most doctors have very little training or imagination with brain stuff. Write down ALL your neurological symptoms you are comfortable talking about. Post another question on sed rates and wbc counts for lyme on another thread and search for them as well. & bring all this to your doc. If you have meningitis and your doc will not deal with this you need another doc. ASAP.
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
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caat
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posted
same goes for all of you BTW...
best of luck!
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
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posted
catt, thanks for your heartful suggestions!
I don't have all the symptoms you listed, but I did suspect qute a few times that I had meningitis.
Would you please tell me how you had your menigitis diagonosed and treated?
SPECT? abx?
I'll do more research and thanks again!!
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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caat
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posted
I diagnosed it then described the symptoms to several doubting docs. All agreed after hearing the symptoms.
I had ataxia- couldn't feel where my feet were- stumbling like drunk, would go to grab a glass and miss, fell a couple times. Reading comprehension went down to a 4th grade level in 2 weeks- had to read things over and over. Grammer got bad. Feelings of rage and irratability. Had a feeling of bugs crawling all over me. Lots of perephrial nervous symptoms- itching, pain. Confusion. Feeling of head pressure. Speach slowed. Memory problems.
That was the worst. It can be more subtle than that. After you know what it is you can start to recognise it when if starts to appear again.
After being refused treatment I treated myself with 400mg animal doxycycline per day and symptoms started to subside immediately. Ataxia stopped in 2 days. Reading level started to get better in 2 weeks. etc. Doxy just held the meningitis at bay for 3 years though till I could get access to IV and then llmd's therapy for co-infections.
Rocephin and flagyl followed by ceftin and tinidazole got rid of lyme. A combo of doxy, rifampin and zith got rid of what might have been bart- AND got rid of the meningitis. Before that every time I went off abx I relapsed to meningitis within 2 to 5 days.
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
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caat
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posted
oh. spect. Cave may be the one to ask about that. I could never afford any of those tests or get my insurance to cover them, so never looked too closely at them.
But I remember everyone was telling people to go for spect rather than mri. At least for lyme itself...
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
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caat
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posted
Justag... I'm sure you know that if it is meningitis you're dealing with it's dangerous... I have minimal damage from all this because I treated myself within a week of those symptoms. Each time I went off the abx and had to restart it took a while to recover comprehension etc. I still have problems recognising people sometimes, and my short term memory is totally shot...
It could have been a lot worse you know...
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
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posted
catt, thanks so much for your reply!!!It gave me relief since I've been on doxy 200mgx2 a day for two weeks and will continue until I see an LLMD in early April.
Right now I'm on BCBS HMO and our insurance will be renewed on April 1st. I'm still waiting to hear back if I could change to BCBS PPO at a much higher premium that LLMD accepts. If not, I would go to that LLMD just paying out of pocket.
I hope I can switch to PPO by paying extra $2,000 a year, but in the mean time, I have no idea how much benefit I can get since I'm fighting with Lyme that insurance companies hate to cover...
I pray God arranges things in order so that I could get better and well, and thanks so much again for your advice!!
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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posted
catt, take care, and you are in my prayer too.
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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tailz
Unregistered
posted
It used to be only my left pupil and eyelid. My left eyelid tended to droop ever so slightly and my left pupil didn't seem to ever dilate (enlarge) as I'd blink my eyelid over it. Now it affects my right eye as well.
It is so bad in fact that I can no longer wear my contacts. I also tend to get a lot of bright green or yellow crust in my eyes.
This did initially improve periodically on Rocephin, but when I was forced to stop infusions due to sky high liver enzymes, future infusions did not affect my pupils. So I'm not sure what happened.
I'm on orals now and do not seem to be improving. I'm hoping warm weather and sunshine will help heal whatever is damaged in my eyes. If it doesn't, I don't know what I'm going to do because I've tried everything and then some.
posted
for me, my right pupil is bigger, and sometimes so obviously bigger than the left one and I was scared looking at it!
Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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caat
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posted
uhmmm... Justag...
200mg of doxy isn't a high enough dose to cross the blood brain barrier. I kept mine at bay for 3 years with 400mg doxy. & sometimes flagyl added. That kept the other infections at bay as well.
Some people have been OK with stuff that doesn't cross the bbb and others have not... I always relapsed at 200mg. Just took a little longer.
I'm doing a lot better Justag. No more meningitis so far.
Posts: 1436 | From Humboldt county ca usa | Registered: Mar 2002
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I do take 400mg doxy a day (200mg x 2). I was feeling better but in the past few days my brain fog and rash are worse. I would read buhner's book for herbel protocols too...
Now I'm sure that with all you guys' knowledge and experience sharing, I won't die young if I persist and learn and get treated Posts: 196 | From atlanta/norcross, georgia | Registered: Feb 2007
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