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Acanthamoeba keratitis: report of three cases.
Bulletin De La Societe Belge D'Ophtalmologie
|January 1, 1989
Summary
Acanthamoeba keratitis can affect contact lens wearers and non-wearers, sometimes linked to swimming. Early diagnosis and varied treatments are crucial for visual recovery, though some cases may require corneal transplantation.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Acanthamoeba keratitis (AK) is a severe microbial infection of the cornea.
- Risk factors include contact lens wear and exposure to contaminated water.
- This study reports on three cases of AK with varied presentations and outcomes.
Observation:
- One patient developed AK after swimming in a contaminated pool while wearing soft contact lenses.
- Two patients had no history of trauma or contact lens wear.
- Diagnosis was confirmed using Calcofluor White staining of corneal scrapings.
Findings:
- Treatment involved a combination of antimicrobial eyedrops (metronidazole, propamidine isethionate, neomycin), topical corticosteroids, and mydriatics.
- One patient achieved full visual recovery within a month.
- Another patient showed near-complete amelioration, while the third, presenting with severe necrotic keratitis, required keratoplasty due to central opacity and ectasia.
Implications:
- Acanthamoeba keratitis presents diverse clinical scenarios, impacting both contact lens users and non-users.
- Prompt diagnosis via specific staining methods is vital for effective management.
- While medical therapy can be successful, advanced cases may necessitate surgical intervention like corneal transplantation for visual rehabilitation.