Contact lens user, presents with severe pain, blurred vision, watering


#1

Q- Clinical history:
Contact lens user, presents with severe pain, blurred vision, watering , photophobia. Examination reveals this picture… Like diagnosis- ???

Acanthamoeba Keratitis
*Causatative Organism - Acanthamoeba castellani

*Contact Lens wearers using home made saline (From contaminated tap water and saline tablets) is the commonest situation recognised for acanthamoeba infection in western countries.

*Non contact Lens related - Trauma with organic matter and exposure to muddy water are the major predisposing factors in developing countries.
Signs –
Initial Lesions – Limbitis, Radial Keratoneuritis

Advanced cases – Patchy stromal Infiltrates, Satellite Infiltrates
****Central/Paracentral Ring Infiltrates

Severe cases - Ring abscess, Hypophon, Stromal necrosis