Acanthamoeba dendriform keratitis

A soft contact lens patient complained of persistent redness, blurry vision and photophobia of the right eye. Both tap water and distilled water were used in his contact lens care regimen. Atypical corneal epithelial dendriform patterns were noted and the patient was treated for presumed herpes simplex keratitis and corneal erosion. The definitive diagnosis of Acanthamoeba dendriform keratitis was made upon isolation of the offending organism from the patient's contact lens case. The clinical course is presented to help define early clinical signs of the disease.