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Acanthamoeba sclerokeratitis

P J Dougherty1, P S Binder, B J Mondino

  • 1Department of Ophthalmology, Jules Stein Eye Institute, UCLA School of Medicine 90024.

American Journal of Ophthalmology
|April 15, 1994
PubMed
Summary
This summary is machine-generated.

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Acanthamoeba scleritis, a severe eye infection in soft contact lens wearers, can cause significant pain and vision loss. Despite aggressive medical and surgical interventions, this condition may lead to enucleation, highlighting its poor prognosis.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Acanthamoeba keratitis is a serious infection of the cornea.
  • Scleritis, inflammation of the sclera, can occur alongside keratitis.
  • Soft contact lens wear is a significant risk factor for Acanthamoeba infections.

Observation:

  • A healthy soft contact lens wearer presented with severe pain and ring-shaped subepithelial infiltrates in the left eye.
  • Scleral nodules developed, and the keratitis progressed despite initial treatment with clotrimazole, dibromopropamidine isethionate, and corticosteroids.
  • Corneal transplantation and cryotherapy were performed, but the disease continued to advance.

Findings:

  • Histopathology confirmed Acanthamoeba cysts in the corneal button and scleral nodules.

Related Experiment Videos

  • Cultures from scleral biopsy specimens were positive for Acanthamoeba.
  • A second corneal graft and polyhexamethylene biguanide eyedrops failed to halt the progression, necessitating enucleation.

    • Implications:

    • Acanthamoeba scleritis is associated with a poor prognosis, even with comprehensive medical and surgical management.
    • Early diagnosis and aggressive treatment are crucial, but may not always prevent severe outcomes.
    • This case underscores the potential severity of Acanthamoeba infections extending to the sclera in contact lens wearers.