What Is Acanthamoeba Keratitis and How Is It Treated?

Written by Medicover Team and Medically Reviewed by Dr Manaswini Priya Varanasi , Ophthalmologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Acanthamoeba keratitis is caused by a microscopic, free-living amoeba called Acanthamoeba. This pathogen is ubiquitous and found in various environmental settings such as soil, dust, and water sources, including tap water and swimming pools. While the organism itself is not harmful to most individuals, it can pose a significant threat to those who wear contact lenses.

Acanthamoeba Keratitis and Contact Lenses

The link between contact lens use and Acanthamoeba keratitis is well-documented. The infection typically occurs when contact lenses come into contact with contaminated water. Practices such as rinsing lenses with tap water, swimming or showering while wearing lenses, or improper lens hygiene can increase the risk of infection. Contact lens wearers should be particularly vigilant about their lens care routines to mitigate this risk.

What are the Symptoms of Acanthamoeba Keratitis?

Recognizing the symptoms of Acanthamoeba keratitis early can significantly enhance the prospects for successful treatment. Common symptoms include:

Severe pain in the eye
Redness and inflammation
Blurred vision
Sensitivity to light (photophobia)
Excessive tearing
A sensation of something in the eye

These symptoms can resemble those of other eye infections, which underscores the importance of seeking professional medical advice for an accurate diagnosis.

What are the Causes of Acanthamoeba Keratitis?

Understanding the causes and risk factors associated with Acanthamoeba keratitis is essential for prevention. The primary cause of infection is the introduction of Acanthamoeba into the cornea, often through contaminated contact lenses. However, several other risk factors can contribute to the development of the condition:

Poor contact lens hygiene
Using homemade saline solutions
Wearing lenses while swimming or showering
Pre-existing corneal trauma or disease

Individuals who engage in these practices are at a heightened risk of contracting Acanthamoeba keratitis.

When to See a Doctor for Acanthamoeba Keratitis?

Acanthamoeba keratitis requires urgent evaluation by an ophthalmologist, a specialized eye care physician who diagnoses and treats corneal infections. Professional assessment is essential when experiencing eye pain, vision changes, or redness, as this rare but serious infection can rapidly damage the cornea and threaten sight.

Symptoms Requiring Medical Attention

Severe eye pain and discomfort that worsens despite over-the-counter pain relief medications or eye drops
Progressive redness and irritation of the affected eye lasting more than a few days, especially in contact lens wearers
Blurred or cloudy vision that develops suddenly or gradually impairs your ability to see clearly
Unusual sensitivity to light accompanied by tearing, discharge, or a gritty sensation in the eye
Ring-shaped infiltration pattern appearing on the cornea or visible white spots around the eye's surface
Persistent symptoms after lens cleaning, even with new lens solution, indicating possible infection rather than irritation

Important: These could be signs of a serious complication like corneal scarring or vision loss, which needs urgent care.

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What are the Diagnosing Acanthamoeba Keratitis?

Accurate diagnosis of Acanthamoeba keratitis can be challenging, given its similarity to other corneal infections. Ophthalmologists typically employ several diagnostic techniques to confirm the presence of Acanthamoeba:

Clinical Examination

The first step in diagnosing Acanthamoeba keratitis involves a thorough clinical examination. This includes assessing the patient's medical history, mainly focusing on contact lens usage and any recent exposure to potential sources of contamination.

Laboratory Tests

Laboratory tests play a crucial role in confirming Acanthamoeba keratitis. Corneal scraping is a standard procedure where a small sample of the corneal tissue is taken and analyzed under a microscope to detect the presence of Acanthamoeba cysts or trophozoites.

Advanced Imaging Techniques

Advanced imaging techniques, such as confocal microscopy, can provide detailed images of the cornea, allowing for the identification of Acanthamoeba. This non-invasive procedure offers high-resolution images, aiding in the early detection of the infection.

What are the Treatment Options for Acanthamoeba Keratitis

Treating Acanthamoeba keratitis requires a multifaceted approach, often involving both pharmacological and non-pharmacological strategies.

Pharmacological Treatments

The cornerstone of Acanthamoeba keratitis treatment is pharmacological intervention. Prescribed medications typically include:

Antiseptic eye drops: Polyhexamethylene biguanide (PHMB) and chlorhexidine are commonly used to target Acanthamoeba cysts and trophozoites.
Antifungal and antibiotic drops: These may be prescribed in conjunction with antiseptic drops to prevent secondary infections.

The treatment regimen is often intensive, requiring frequent application of drops, especially in the initial stages, to eradicate the infection effectively.

Surgical Interventions

In cases where pharmacological treatment is insufficient, surgical intervention may be necessary. Procedures such as corneal debridement, where damaged tissue is removed, or a corneal transplant may be considered for severe cases where significant corneal damage has occurred.

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What are the Preventing of Acanthamoeba Keratitis?

Prevention is paramount in mitigating the risks associated with Acanthamoeba keratitis, particularly for contact lens users. Key preventive measures include:

Adhering to strict contact lens hygiene practices, such as cleaning and storing lenses as per the manufacturer's instructions.
Avoid exposure to contaminated water while wearing contact lenses.
Regularly replacing contact lens storage cases.
Using commercially prepared sterile saline solutions for rinsing lenses.

These preventive strategies can significantly reduce the likelihood of developing Acanthamoeba keratitis.

Acanthamoeba keratitis is a potentially devastating eye infection that requires prompt diagnosis and effective treatment to prevent severe complications, including vision loss. Understanding the symptoms, risk factors, and treatment options is essential for both healthcare professionals and individuals, particularly those who use contact lenses. By adhering to recommended preventive measures and seeking timely medical attention, the risk of infection can be substantially minimized, ensuring the preservation of eye health.

In summary, while rare, Acanthamoeba keratitis poses a significant threat to ocular health, particularly among contact lens users. Through awareness, proper hygiene practices, and early intervention, the impact of this condition can be effectively managed and reduced.