Acanthamoeba keratitis in fluorescein stain

A 23-year-old Indian myopic lady with a history of contact lens use presented with blurred vision and severe pain in the right eye for 1 week. It was gradual and worsening. On slit-lamp examination, a plaque-like lesion on the inferior side of the cornea was seen and in in-vivo fluorescein staining [Fig. 1a and b]. Epithelial pseudo-dendrites were seen in in-vivo fluorescein staining. No kerotoneuritis was observed. Corneal scraping revealed an Acanthamoeba cyst with a double-layered cyst wall seen in in-vitro fluorescein staining [Fig. 1c].[1,2] Subsequent culture of the remaining specimen and contact lens in non-nutrient agar with E. coli overlay revealed the organism.[1]Figure 1: (a) Slit-lamp photograph showing a plaque-like lesion on the inferior corneal surface of the right eye. (b) showing an active lesion in fluorescein stain under cobalt blue light. (c) Showing a globular Acanthamoeba cyst in fluorescein stain. The double layer of the cyst (marked by a black arrow) was characteristic of Acanthamoeba (×100 X, oil immersion lens; Axioskop 40, Axio Cam MRc ZEISS, Germany)Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.