Acanthamoeba keratitis and contact lens wear

Area of Science:

• Ophthalmology
• Microbiology
• Infectious Diseases

Background:

• Acanthamoeba keratitis (AK) is a rare but severe contact lens complication potentially causing significant vision loss.
• Early symptoms, including severe pain disproportionate to signs, can mimic herpes simplex virus (HSV) keratitis, leading to misdiagnosis.
• Advanced AK involves corneal epithelial loss and stromal opacification, resulting in vision impairment.

Purpose of the Study:

• To describe six cases of contact lens-related Acanthamoeba keratitis in Australia and New Zealand.
• To identify risk factors and treatment outcomes for these cases.
• To emphasize preventive strategies for Acanthamoeba keratitis.

Main Methods:

• Case series analysis of six patients with contact lens-related AK.
• Review of patient history, lens type, maintenance practices, and exposure to water.
• Assessment of treatment regimens, including medical therapy and surgical interventions.

Main Results:

• Six cases of AK were identified over three years, involving disposable soft, hybrid, and rigid gas permeable lens wearers.
• Common risk factors included improper lens maintenance and exposure to tap or other water sources.
• All patients responded to medical treatment with polyhexamethylene biguanide and propamidine isethionate; two required subsequent keratoplasty for residual scarring.

Conclusions:

• Contact lens wear associated with inadequate hygiene and water exposure are significant risk factors for AK.
• Prompt medical treatment is effective, but prevention through patient education on proper lens care, especially avoiding water contamination, is essential.
• Continued vigilance and education are necessary to reduce the incidence of this sight-threatening condition.