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Acanthamoeba keratitis

C D Illingworth1, S D Cook

  • 1Bristol Eye Hospital, United Kingdom.

Survey of Ophthalmology
|June 23, 1998
PubMed
Summary
This summary is machine-generated.

Acanthamoeba keratitis, a severe eye infection linked to contact lens use, causes inflammation and vision loss. Early diagnosis and treatment with specific agents are crucial for successful outcomes.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Acanthamoeba species are a significant cause of microbial keratitis, leading to severe ocular inflammation and potential vision loss.
  • The incidence of Acanthamoeba keratitis increased notably in the 1980s, primarily associated with contact lens wear, especially when using non-sterile solutions.
  • Risk factors include improper contact lens hygiene, such as using tap water or homemade saline solutions.

Purpose of the Study:

  • To review the etiology, clinical presentation, diagnosis, and management of Acanthamoeba keratitis.
  • To highlight the association between contact lens wear and the increased incidence of this infection.
  • To discuss current therapeutic strategies and their effectiveness.

Main Methods:

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  • Review of existing literature on Acanthamoeba keratitis.
  • Analysis of clinical case reports and epidemiological data.
  • Summary of diagnostic techniques, including culture and microscopy.
  • Evaluation of various topical therapeutic agents and treatment outcomes.

    • Main Results:

    • Acanthamoeba keratitis presents with severe pain and characteristic corneal infiltrates, often initially misdiagnosed.
    • Diagnostic methods include culture on bacterial-infused agar plates and direct microscopy with specific stains or immunostaining.
    • Effective treatments involve topical agents like propamidine isethionate, clotrimazole, polyhexamethylene biguanide, and chlorhexidine.
    • Early treatment initiation significantly improves the chances of medical cure.

    Conclusions:

    • Prompt diagnosis and early intervention are critical for managing Acanthamoeba keratitis and preventing vision loss.
    • Contact lens hygiene practices are paramount in reducing the risk of this infection.
    • While medical management is often successful, penetrating keratoplasty may be required in severe or refractory cases.