They should do a Lyme test on your CSF. Also if you were treated with antibiotics, your titer is basically frozen where you took the abx. I had Lyme 15 years ago and now have autoimmune issues. I had the EM rash. I believe my dog brought the tick in my house, and I sat on it. Was bitten in the thigh. I did not know it for days until I scratched off what I thought was a small scab. I live in an endemic area tho, so it could have come from anywhere. Those Lyme tests are very inaccurate.

My titer started to climb and then stopped under the cut off for +. So I test negative, except when they do bands. And I was diagnosed and treated within 2 weeks of the bite...and had a classic EM rash, that was quite big.

I would seriously consider some transmissible disease, due to the acute onset.

Have they done a brain MRI?

Short of it being Lyme, have the ANA repeated....an FANA, the expensive kind. Your post implied you are a male, and the chances of autoimmune disease are less than in females, but not impossible. Dry eyes can be neurological or inflammatory. Other tests that pick up inflammation, sed rate, C-reactive protein, platelet count (high) CD4/CD8 ratio....eh, but you knew that already. Don't think you don't have a substantial knowledge base....a lot of research applied to people is done on animals....we share a lot.

Your presentation seems very acute.

Mine evolved over decades.

Good luck to you and I hope you find an answer.