We present eight cases of Acanthamoeba keratitis. In each case, the Ac
anthamoeba organisms were visualized in the epithelium and anterior st
roma using tandem scanning confocal microscopy. The organisms were hig
hly reflective, ovoid, and were 10-25 mu m in diameter. The Acanthamoe
ba organisms in the human corneas were identical in size and shape to
Acanthamoeba organisms on an agar plate visualized with the same confo
cal microscope. Confocal microscopy is a useful method for identifying
Acanthamoeba organisms in vivo within the corneal epithelium and ante
rior stroma.