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Atypical presentation of Acanthamoeba keratitis
1Department of Ophthalmology, University of Vermont, 1 South Prospect St., Burlington, VT 05401, U.S.A. geoffrey.tabin@vtmednet.org
Cornea
|October 6, 2001
Summary
Acanthamoeba keratitis can present with minimal pain, challenging typical diagnoses. Clinicians should consider Acanthamoeba in atypical keratitis cases, even without severe pain or contact lens use.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Acanthamoeba keratitis (AK) is a serious eye infection often associated with severe pain and contact lens wear.
- This study highlights atypical presentations of AK that may be missed by clinicians.
Observation:
- Two cases of AK are presented in patients with minimal subjective pain.
- One patient was a professional athlete with a high pain tolerance who swam in fresh water.
- The second patient had known herpes simplex keratitis and decreased corneal sensation.
Findings:
- Both patients were diagnosed with AK via corneal biopsy.
- Despite intensive treatment, visual acuity remained significantly impaired in both cases, necessitating corneal transplantation in one.
- These cases demonstrate that AK can occur without the classic severe pain or predisposing factors.
Implications:
- Clinicians must consider AK in the differential diagnosis of keratitis, especially in atypical presentations.
- Early recognition and treatment are crucial, but outcomes can be poor even with prompt management.
- The findings emphasize the need for heightened awareness of AK in diverse clinical scenarios.
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