Acanthombea Keratitis

Question 1

What is Acanthamoeba Keratitis?

Answer 1

An infection caused by protozoa found in well water, drains, soil, dust, and domestic tap water. It can be bilateral.

Question 2

What are the main signs of Acanthamoeba Keratitis?

Answer 2

• Epithelial or subepithelial infiltrates
• Pseudodendrites
• Radial keratoneuritis (infiltrates along corneal nerves)
• Recurrent breakdown of the corneal epithelium
• Deep corneal inflammation (ring-shaped or disciform infiltrate)
• Stromal thinning
• Extension of inflammation into the sclera
• Anterior chamber cells and flare
• Hypopyon

Question 3

What are the common symptoms of Acanthamoeba Keratitis?

Answer 3

• Pain
• Visual loss
• Redness
• Epiphora (excessive tearing)
• Photophobia

Question 4

What is radial keratoneuritis in Acanthamoeba Keratitis?

Answer 4

Infiltrates along the corneal nerves causing radial patterns in the cornea.

Question 5

What is the first step in managing Acanthamoeba Keratitis?

Answer 5

Emergency (same day) referral to an ophthalmologist without intervention. Delay is associated with poorer prognosis.

Question 6

Why is it important to telephone the hospital before referring a patient with Acanthamoeba Keratitis?

Answer 6

To ensure that the patient is expected, emphasize the urgency, and leave a message with a doctor or healthcare professional.

Question 7

What should patients with Acanthamoeba Keratitis bring to the hospital?

Answer 7

Their contact lenses and lens case for possible culture.

Question 8

What topical medical therapies are used for Acanthamoeba Keratitis?

Answer 8

• Biguanide (PHMB)
• Diamidine (Brolene)
• A combination of both

Question 9

How long does treatment for Acanthamoeba Keratitis typically last?

Answer 9

Continuous therapy may be required for weeks or months.

Question 10

When are topical steroids used in Acanthamoeba Keratitis management?

Answer 10

To limit inflammation, in conjunction with other treatments.

Question 11

Why is early diagnosis crucial in Acanthamoeba Keratitis?

Answer 11

Early diagnosis is essential for effective treatment as the cyst form of the protozoa makes the infection difficult to treat.

Question 12

What is a possible long-term complication of Acanthamoeba Keratitis if untreated or severe?

Answer 12

Corneal transplant may be required to restore vision.

Question 13

How does Acanthamoeba Keratitis affect the corneal epithelium?

Answer 13

It can cause recurrent breakdown of the corneal epithelium.

Question 14

What is hypopyon in the context of Acanthamoeba Keratitis?

Answer 14

Accumulation of white blood cells in the anterior chamber, indicating severe inflammation.

Question 15

What is stromal thinning in Acanthamoeba Keratitis?

Answer 15

Thinning of the corneal stroma due to severe inflammation.

Question 16

How can the inflammation from Acanthamoeba Keratitis spread?

Answer 16

It can extend into the sclera, causing more widespread inflammation.

Question 17

What role do systemic analgesics play in managing Acanthamoeba Keratitis?

Answer 17

They provide pain relief as part of intensive therapy.

Question 18

What is the role of corneal transplant in Acanthamoeba Keratitis?

Answer 18

It may be required in severe cases to restore vision after significant corneal damage.

Question 19

Why is Acanthamoeba Keratitis difficult to treat?

Answer 19

The cyst form of the protozoa is resistant to treatment, making the infection more challenging to manage.

Question 20

What is the prognosis for Acanthamoeba Keratitis?

Answer 20

The prognosis depends on early diagnosis and treatment. Delay can result in severe outcomes, including corneal transplant.