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Acanthamoeba keratitis: risk factors and outcome
C D Illingworth1, S D Cook, C H Karabatsas
1Department of Ophthalmology, Bristol Eye Hospital, Bristol.
The British Journal of Ophthalmology
|December 1, 1995
Summary
Acanthamoeba keratitis, a serious eye infection, saw increased incidence in the 1990s, primarily affecting contact lens wearers. Early diagnosis and treatment lead to good visual outcomes, with medical therapy often sufficient for cure.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Acanthamoeba keratitis (AK) is a sight-threatening infection of the cornea.
- Risk factors and treatment outcomes for AK require ongoing investigation.
Purpose of the Study:
- To investigate the risk factors associated with Acanthamoeba keratitis.
- To evaluate the treatment outcomes for patients diagnosed with Acanthamoeba keratitis.
Main Methods:
- A retrospective case series of 22 patients (23 eyes) with Acanthamoeba keratitis treated at Bristol Eye Hospital between 1985 and February 1995.
- Data collection included patient demographics, contact lens use, disinfection methods, diagnostic delays, and treatment regimens.
- Contact lens-related information was also gathered for two additional patients.
Main Results:
- The incidence of AK significantly increased in the 1990s, with all patients being contact lens wearers.
- Daily wear disposable contact lenses were used by 67% of patients; 50% used chlorine disinfectant, and 18% used no disinfectant.
- Delayed diagnosis (≥6 weeks) was noted in 39% of eyes requiring penetrating keratoplasty. Despite this, 78% of eyes achieved a final visual acuity of 6/6 or better.
Conclusions:
- Acanthamoeba keratitis incidence rose in the 1990s, strongly linked to contact lens wear.
- Early diagnosis is crucial for favorable visual outcomes, with medical therapy often leading to cure.
- Most patients can achieve good visual acuity with appropriate treatment.