Acanthamoeba Keratitis: Symptoms, Causes, Treatment

What are the symptoms of Acanthamoeba keratitis?

Acanthamoeba keratitis is a rare but serious eye infection caused by a microscopic organism called Acanthamoeba. The symptoms of acanthamoeba keratitis can vary but often include:

1. Eye Pain: Severe, persistent eye pain that is not relieved by over-the-counter pain relievers.
2. Redness and Irritation: The affected eye may appear red, and there may be irritation or a feeling of something in the eye.
3. Sensitivity to Light: Increased sensitivity to light (photophobia) is common.
4. Blurred Vision: Vision may become blurry or cloudy, and there may be difficulty focusing.
5. Excessive Tearing: The eye may tear excessively, leading to watery eyes.
6. Feeling of Something in the Eye: The sensation of having something in the eye (foreign body sensation).
7. Difficulty Wearing Contact Lenses: If the person wears contact lenses, they may experience discomfort or difficulty wearing them.
8. Corneal Inflammation: In advanced cases, the cornea (the clear, outer layer of the eye) may become inflamed, leading to more severe symptoms.

It’s important to note that these symptoms can also be caused by other eye conditions, so a proper diagnosis by an eye care professional is necessary. Acanthamoeba keratitis is typically diagnosed through a comprehensive eye examination and laboratory testing of a sample from the eye. Early diagnosis and treatment are important to prevent complications and preserve vision.

What are the causes of Acanthamoeba keratitis?

Acanthamoeba keratitis is caused by exposure to a microscopic organism called Acanthamoeba, which is commonly found in the environment, especially in soil, dust, and fresh water sources. The infection occurs when the organism enters the eye, usually through:

1. Contact Lenses: Improper cleaning and disinfection of contact lenses, as well as wearing them while swimming or in hot tubs, can increase the risk of Acanthamoeba keratitis.
2. Contaminated Water: Exposure to contaminated water, such as while swimming, using tap water to rinse contact lenses, or using homemade saline solutions, can introduce the organism to the eye.
3. Corneal Trauma: Injuries to the cornea, such as scratches or abrasions, can provide a pathway for Acanthamoeba to enter the eye.
4. Weakened Immune System: Individuals with a weakened immune system, such as those with HIV/AIDS or taking immunosuppressive medications, may be at higher risk of developing Acanthamoeba keratitis.
5. Exposure to Soil or Dust: Activities that involve exposure to soil or dust, such as gardening or working with compost, can increase the risk of exposure to Acanthamoeba.

It’s important to note that Acanthamoeba keratitis is rare and most commonly affects contact lens wearers who do not follow proper lens care practices. Proper hygiene and care of contact lenses, including using sterile solutions and avoiding exposure to water while wearing lenses, can help reduce the risk of infection.

What is the treatment for Acanthamoeba keratitis?

The treatment for acanthamoeba keratitis can be challenging and often requires a combination of medications and supportive care. The goal of treatment is to eliminate the Acanthamoeba organism, reduce inflammation, and prevent complications. Here are the primary treatment options:

1. Medications:

• Topical Antimicrobial Agents: Prescription eye drops or ointments containing antimicrobial agents, such as chlorhexidine or polyhexamethylene biguanide (PHMB), are typically used to kill the Acanthamoeba organism.
• Topical Anti-inflammatory Agents: Corticosteroid eye drops may be prescribed to reduce inflammation and discomfort.
• Oral Medications: In some cases, oral medications may be prescribed to help fight the infection, especially if it is severe or has spread beyond the eye.

1. Corneal Debridement: In some cases, the outer layer of the cornea (corneal epithelium) may need to be removed to allow the medications to penetrate deeper into the cornea.
2. Pain Management: Over-the-counter or prescription pain relievers may be recommended to manage pain and discomfort.
3. Contact Lens Care: If the infection is associated with contact lens use, it is important to stop wearing contacts and follow proper lens care practices.
4. Surgery: In severe cases of acanthamoeba keratitis that do not respond to other treatments, surgery may be necessary. This can include corneal transplantation to replace the damaged cornea with a healthy donor cornea.
5. Close Monitoring: Regular follow-up visits with an eye care professional are important to monitor the progress of treatment and make any necessary adjustments.

Treatment for acanthamoeba keratitis can be prolonged and may require weeks to months of therapy. It is important to follow your healthcare provider’s instructions carefully and attend all follow-up appointments to ensure the infection is properly treated and to prevent complications.