Acanthamoeba Keratitis

Acanthamoeba Keratitis
SYMPTOMS Pain (usually severe) | Photophobia | Blurry vision
SIGNS Injection | Epitheliopathy | Corneal haze | Ring-shaped infiltrate | Anterior chamber cells/flare | Hypopyon
WORK-UP Thorough history and slit lamp examination | Culture and possible corneal biopsy | Confocal biomicroscopy may be used
TREATMENT Discontinue contact lens wear (if applicable) | A combination of biguanides (PHMB, chlorhexidine), diamidines (propamidine-isethionate), antibiotics and antifungals | Oral analgesics (acetaminophen, ibuprofen, possible narcotic agents)
ADDITIONAL LAB | TESTS Culture | Corneal biopsy | Confocal biomicroscopy
ETIOLOGY Acanthamoeba
DIFFERENTIAL DX Herpes simplex keratitis | Herpes zoster ophthalmicus | Recurrent corneal erosion
NOTES Ask patients about contact lens wear, specifically rinsing/cleaning with tap water and/or swimming