A 29-year-old woman presented with clinical signs and symptoms of Acan
thamoeba keratitis. Scanning slit confocal microscopy revealed a 26-mu
-diameter object, resembling an Acanthamoeba cyst, in the anterior str
oma. Numerous ovoid objects (possibly inflammatory cells, trophozoites
, or altered keratocytes) were present. Normal keratocyte nuclei and t
he anterior corneal mosaic, readily imaged by scanning slit confocal m
icroscopy of the normal cornea, were noticeably absent. Subsequent cor
neal biopsy confirmed the diagnosis of Acanthamoeba keratitis.