Acanthamoeba Keratitis

• Most commonly associated with contact lens use, corneal trauma and history of exposure to possibly contaminated fresh water.

Clinical Features

• Symptoms:
  • Foreign body sensation, severe ocular pain, photophobia and blurred vision
  • Often pain is more severe than signs in early course of the disease
• Signs:
  • Usually unilateral diffuse punctate epitheliopathy, dendritic epithelial lesion which may gradually progress to stromal infection associated with ring infiltrate formation
  • Enlarged corneal nerve ( keratoneuritis) is patognomonic of the infection
  • Scleritis may be found in advanced cases

Management

• Early diagnosis a prognostic factor of a successful outcome.
• Epithelial debridement.
• Topical anti-amoeba agents.
• Penetrating keratoplasty in a severe progressive keratitis.