What are the best treatments for Acanthamoeba keratitis?

Treatments for Acanthamoeba Keratitis

Acanthamoeba keratitis is a rare but serious eye infection caused by a microscopic organism called Acanthamoeba. It primarily affects contact lens wearers, but can also occur in individuals with corneal injuries or compromised immune systems. Prompt and appropriate treatment is crucial to prevent vision loss and complications. Here are some of the best treatments for Acanthamoeba keratitis:

1. Medications:

The mainstay of treatment for Acanthamoeba keratitis involves the use of various medications. These medications are typically prescribed by an ophthalmologist and may include:

• Topical Antimicrobial Agents: Eye drops or ointments containing antimicrobial agents, such as polyhexamethylene biguanide (PHMB), propamidine isethionate, or chlorhexidine, are commonly used to kill the Acanthamoeba organisms.


• Antifungal Medications: In some cases, antifungal medications like voriconazole or natamycin may be prescribed to treat associated fungal infections that can occur alongside Acanthamoeba keratitis.


• Pain Relief: Eye drops or oral pain medications may be recommended to alleviate the discomfort and pain associated with the infection.


• Steroids: In certain situations, corticosteroid eye drops may be used to reduce inflammation and promote healing. However, their use is controversial and should only be initiated under close supervision by an eye care professional.

2. Debridement:

Debridement is a procedure performed by an ophthalmologist to remove infected tissue from the cornea. This helps to eliminate the Acanthamoeba organisms and prevent further damage. Debridement is typically done using a sterile instrument or a soft brush, and it may need to be repeated several times during the course of treatment.

3. Corneal Transplantation:

In severe cases of Acanthamoeba keratitis where there is extensive corneal damage or poor response to medications, a corneal transplantation may be necessary. During this procedure, the damaged cornea is replaced with a healthy donor cornea. Corneal transplantation can help restore vision, but it is considered a last resort due to the risks involved.

4. Rigorous Contact Lens Hygiene:

Prevention is always better than cure, and practicing good contact lens hygiene is essential to reduce the risk of Acanthamoeba keratitis. Some important measures include:

• Proper Cleaning and Disinfection: Follow the recommended cleaning and disinfection guidelines for your contact lenses. Use only sterile solutions and avoid tap water or homemade saline solutions.


• Regular Replacement: Replace your contact lenses as recommended by your eye care professional. Do not wear them beyond their recommended lifespan.


• Avoid Water Contact: Remove your contact lenses before swimming, using hot tubs, or coming into contact with water sources like showers or lakes.


• Proper Storage: Store your contact lenses in a clean case and replace the case regularly to prevent contamination.

5. Close Monitoring and Follow-up:

Regular follow-up visits with an ophthalmologist are crucial during the treatment of Acanthamoeba keratitis. The progress of the infection needs to be closely monitored, and adjustments to the treatment plan may be made based on the response to medications and the overall condition of the eye.

It is important to note that self-diagnosis and self-medication should be avoided in cases of suspected Acanthamoeba keratitis. Only a qualified eye care professional can accurately diagnose and provide appropriate treatment for this condition.

Early detection, prompt treatment, and strict adherence to the prescribed medications and hygiene practices are key to successfully managing Acanthamoeba keratitis. If you experience any symptoms such as eye pain, redness, blurred vision, or sensitivity to light, seek immediate medical attention to prevent potential complications.