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Acanthamoeba Keratitis:

                                            The Ocular Nightmare










                                               ABSTRACT

                                               Acanthamoeba keratitis is an ocular disease caused by a microscopic
                                               protozoan, identified as an Acanthamoeba. Acanthamoebae are found
                                               commonly in freshwater, sea water, and soil throughout the world. Normal
                                               exposure to Acanthamoebae usually does not cause problems to the
                                               exposed individual. However, exposure of Acanthamoeba to an individual
                                               with a corneal abrasion as a result of trauma or contact-lens wear can lead
                                               to severe corneal disease. This infection can cause vision loss or even
                                               require enucleation. Prevention, correct diagnosis, and treatment are
                                               essential in the management of A. keratitis. A case study will be discussed
            Author:                            as part of this article.
            Craig R. Pataky,
            BCO, BADO
            Austin Ocular Prosthetics Center,     Introduction
               LLC                          Acanthamoeba is a facultative parasite responsible for causing primary
            Austin, Texas                   amebic keratitis and fatal granulomatous encephalitis in humans.
                                                                                                    1
                                            Acanthamoebae are a member of the family Hartmannellidae with multiple
                                            species including A. culbertsoni, A. polyphaga, A. hatchetti, A. castellanii,
                                            and A. rhysodes, among others. “The factors that contribute to Acan-
                                            thamoeba infections include parasite biology, genetic diversity, environ-
                                            mental spread and host susceptibility and are highlighted together with
                                            potential therapeutic and preventative measures.” 2

                                            History and Details of Acanthamoeba
                                            Amoebae have been found by way of fossil records to date back 400 million
                                            years. Amoebae were among the first organisms to be studied since the
            Correspondence to:              microscope was invented. Amoebae were found to cause bloody dysentery
                                            in a patient in 1873. Among free-living amoebae, Naegleria was discovered
            Craig R. Pataky, BCO, BADO
            Austin Ocular Prosthetics Center, LLC  by Schardinger in 1899. Acanthamoeba was first identified in 1930 by
            4409 Medical Parkway            A. Castellani as a eukaryotic cell culture contaminant of a yeast culture. 3
            Austin, Texas 78756                More attention has been given to amoebae during the last two decades
            Phone: (512) 452-3100           because of the increase of human infections caused by the organisms.
            Fax: (512) 452-3200
            Email: cpataky@austin.rr.com
            Key Words
            Acanthamoeba keratitis, corneal
            epithelium, cyst, trophozoite,
            antiseptic drug

            38  |  PATAKY                                                JOURNAL OF OPHTHALMIC PROSTHETICS
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