Investigations

Acanthamoeba keratitis

 Slit lamp examination with a high intensity focused light along with fluorescein dye staining of the ulcer is helpful in diagnosing corneal ulcers.
Keratometry is done. Scrapings from the ulcer are examined microscopically with stains to confirm the presence of bacteria or fungi. Culture the material from the ulcer is performed to confirm diagnosis due to presence of an organism.

 When present in the eye, Acanthamoeba strains can cause acanthamoebic keratitis, which may lead to corneal ulcers or even blindness. Most common among contact lens wearers who do not properly disinfect their lenses, exacerbated by a failure to wash hands prior to handling the lenses. Multipurpose contact lens solutions are largely ineffective against Acanthamoeba, whereas hydrogen peroxide-based solutions have good disinfection characteristics.

Acanthoamoeba keratitis

 To detect Acanthamoeba on a contact lens in a laboratory, a sheep blood agar plate with a layer (a lawn) of E. coli is made. Part of the contact lens is placed on the agar plate. If Acanthamoeba are present, they will ingest the bacteria, leaving a clear patch on the plate around the area of the lens. Polymerase chain reaction can also be used to confirm a diagnosis of Acanthamoeba keratitis, especially when contact lenses are not involved.

Acanthameoba is also characterized by a brawny edema and hazy view into the anterior chamber. Late stages of the disease also produces a ring shaped corneal ulcer.

Acanthoamoeba keratitis