What Is Acanthamoebic Keratitis: Symptoms, Occurrence, Diagnosis And Treatment

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What Is Acanthamoebic Keratitis: Symptoms, Occurrence, Diagnosis And Treatment
What Is Acanthamoebic Keratitis: Symptoms, Occurrence, Diagnosis And Treatment

Video: What Is Acanthamoebic Keratitis: Symptoms, Occurrence, Diagnosis And Treatment

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Video: Acanthamoeba Keratitis Introduction, Clinical Features, Investigation and Treatment 2023, February
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  • Symptoms
  • Causes of occurrence
  • The main routes of infection through lenses
  • Diagnostics
  • Treatment
  • You can defeat parasites!

Acanthamoeba keratitis is an inflammatory disease of the cornea that causes the penetration of the amoeba (amoebae are among the protozoa) acanthamoeba. It can cause permanent visual impairment and even blindness.

But given that currently about 2% of the world's population wears contact lenses, keratitis, its treatment and prevention is a very urgent problem.

The last point is very important, since it was the widespread use of contact lenses that made ophthalmologists pay attention to this disease and identify its cause. It turned out that the disease occurs due to improper or insufficient care of contact lenses.

It was first described in the specialized literature in 1974, and since then there have been many scientific works devoted to its diagnosis and treatment.

In addition, there is a risk of developing keratitis:

  • with dry eye syndrome, when a lack of tear fluid causes a decrease in local immunity, which facilitates the penetration of microbial agents;
  • with diabetes mellitus, when the body's ability to resist infections is reduced;
  • after surgical intervention (operations) on the eyes, when it takes quite a long time to restore the protective layer of the cornea.
Acantomeba in the human eye
Acantomeba in the human eye
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Image

Symptoms

This disease is characterized by a long chronic course with a rather unfavorable prognosis, if it is not diagnosed and treated in time.

Manifestations of acanthamoebic keratitis may not necessarily occur in both eyes at once, sometimes only in one.

At first, there is an uncomfortable feeling that there is some kind of foreign body under the upper eyelid, then there is a slight irritation, visual acuity decreases slightly.

If at the initial stage you do not consult an ophthalmologist, the disease will only progress: along with a drop in visual acuity, the eyes periodically begin to hurt, redness of the eyeball, lacrimation and photophobia appear, as well as blepharospasm, that is, involuntary spasmodic closure of the eyelids.

As a rule, blepharospasm is considered a neurological disease, so it is very important to immediately diagnose its cause, taking into account other symptoms.

If measures are not taken in time, the development of keratitis will lead to constant and very severe pain in the area of ​​the eyeballs, visual acuity will sharply decrease, so that the patient will be able to distinguish only light and darkness, and, ultimately, all this will lead to complete blindness.

But that's not all: complications such as:

  • iridocyclitis - an inflammatory lesion of the iris and ciliary body of the eye;
  • scleritis - inflammation of the sclera of the eye, which is acute;
  • secondary glaucoma - increased intraocular pressure, fraught with blindness;
  • perforation (perforation) of the cornea.

Take a disease test

Symptoms Answer Redness Yes Not Feeling like there is a foreign body in the eye Yes Not Lachrymation Yes Not Photophobia Yes Not Decreased visual acuity Yes Not Sharp pain Yes Not Blurred vision Yes Not Annular corneal opacity Yes Not Swelling of the eyelids Yes Not Vascularization Yes Not

Causes of occurrence

As already mentioned, the causative agents of acanthamoebic keratitis are free-living amoebae of several genera Acanthamoeba, whose habitat is soil, tap water, stagnant bodies of water, swimming pools, sewer pipes, etc.

The amoeba has two forms of existence: active (trophozoite) and inactive (cyst). In the form of a cyst, it not only retains its viability for a long time, but also has a high resistance to adverse external influences, such as temperature changes, radiation, water chlorination.

When favorable conditions appear, the cyst easily turns into an active form and begins to produce special enzymes that make it easier for the amoeba to enter the human body.

In a healthy state, a person has sufficient resistance (resistance) to the introduction of an inactive amoeba into his body.

However, as soon as the slightest trauma occurs in the cornea, the path of infection is open, since the amoeba can nest even in the microscopic space, it can easily penetrate the cornea.

The main routes of infection through lenses

  • violation of the rules for storing, caring for them and using tap water for rinsing them;
  • non-compliance with the rules of wearing (they must be removed at night, before a shower and a hot bath, in a sauna);
  • not washing hands thoroughly before taking off / putting on;
  • non-observance of the terms of use of the case (it needs to be changed every 3 months);
  • swimming in a pond or pool with polluted water.

Compliance with all of the above points will be the best prevention.

Infection through contact lenses
Infection through contact lenses
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Image

Diagnostics

The main diagnostic method for keratitis is slit lamp biomicroscopy.

Diagnostics should be carried out only by a narrow specialist - an ophthalmologist, who will be able to visually recognize the signs of this formidable disease already at the initial stage: on the cornea, you can see point erosion and epithelial edema; if the disease is running, then the folds of the descement membrane, the edematous stroma (main substance) of the cornea, and the ulcer formed on it are visible.

To clarify the diagnosis, additional methods are also used with the use of special equipment: they measure the thickness of the cornea (pachymetry) and its curvature (keratometry).

For microbiological studies, staining or sowing of scrapings from the cornea on a special nutrient medium is performed.

Treatment

As a rule, in the early stages of acanthamoebic keratitis, sick people use some kind of eye drops to relieve pain in the eyes, and some headache remedies to relieve headaches.

The word "some" here is not accidental, because only a specialist can determine which drops are needed, self-medication will not just not give a result, but for a while will only drown out the symptoms to some extent, but will not stop the development of the disease.

How it looks in later stages can be seen in the photo, and believe me - this is not a sight for the faint of heart.

Conservative therapy includes eye drops (at least 6 weeks), antiseptics, antifungal and antibacterial drugs, and corticosteroids.

To relieve pain, analgesics are prescribed inside. In more serious cases, when a corneal ulcer has formed, it is necessary to resort to surgical intervention.

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