ACANTHAMOEBA-KERATITIS - A MASQUERADE OF PRESENTATION IN 6 CASES

Acanthamoeba keratitis is an uncommon but devastating complication of contact lens wear causing significant ocular morbidity. Six consecutiv e cases occurring in Western Australia in an 18-month period are repor ted. In all cases either poor contact lens hygiene or an association w ith swimming pools and contact lens use is a feature. There is invaria bly a delay in making the diagnosis, with the appearance frequently mi staken for herpes simplex keratitis. In all cases corneal biopsy was r equired to confirm the diagnosis. Of the six patients, four responded to medical therapy alone, one required a corneal graft and one require d enucleation. We suggest that earlier rather than later corneal biops y is important in unresponsive cases of culture-negative keratitis, es pecially in contact lens wearers. We would agree that the treatment of choice is intensive topical propamidine and neosporin. Prevention by strict adherence to contact lens care and hygiene is urged.