Five cases of paralytic strabismus as a rare feature of lyme disease.

Lyme borreliosis is the most common human tick-borne disease in the Northern Hemisphere. The prevalence of Lyme borreliosis is estimated to be 20-100 cases per 100,000 persons in the United States and 100-155 cases per 100,000 persons in Europe [ 1 , 2 ]. It is caused by the spirochete Borrelia burgdorferi sensu lato [ 2 , 3 ]. The course of clinical manifestations is thought to occur in 3 stages: early, disseminated, and chronic [ 2 , 4 ]. Lyme borreliosis can cause a variety of ocular manifestations, and the frequency of these manifestations among cases of Lyme disease involving systemic manifestations is approximately 1% [ 5 ].