A 39-year-old black woman presented with a clinical picture of aseptic meningitis. She was subsequently found to have Lyme disease, a tick transmitted spirochetal disease not unlike syphilis. Approximately 1 month after intensive antibiotic therapy including 128 million units of intravenous penicillin and 28 g of oral tetracycline, she developed symptoms of classical optic neuritis with painful loss of vision and optic disc edema. A discussion of this patient's clinical course, as well as the dermatologic, neurologic, and ocular manifestations of Lyme disease are presented.