Purpose: To report a case of Lyme disease presenting as unilateral posterior stromal keratitis in a pediatric patient.
Methods: Case report and review of available literature.
Results: A 13-year-old adolescent with unilateral painless blurry vision presented with prominent posterior corneal stromal haze. A positive Borrelia burgdorferi antibody enzyme immunoassay and Western blot analysis (9 of 10 reactive immunoglobulin G bands and 1 of 3 immunoglobulin M bands) confirmed the diagnosis. Treatment with oral antibiotics and topical corticosteroids were necessary for resolution.
Conclusions: Lyme disease may present as a unilateral posterior stromal keratitis, even in a pediatric population. Treatment requires both systemic and topical therapy.