Severe Acanthamoeba sclerokeratitis in a non-contact lens wearer

To report a case of severe Acanthamoeba sclerokeratitis.

A 70-year-old male non-contact lens wearer was examined for severe pain in the left eye which began about 40 days after cataract surgery. In spite of a careful search, it required 6 weeks to detect Acanthamoeba. Systemic and topical fluconazol and miconazol did not help and the keratitis progressed into necrotic sclerokeratitis with protrusion of uveal tissue through the thin sclera.

Those findings slowly got worse before the Acanthamoeba sclerokeratitis resolved 6 months later with scar formation.

We describe the terminal and cicatricial stages of Acanthamoeba keratitis, and report that the healing process can follow the terminal stage and the eye does not need to be enucleated.