Managing clinical conditions: Acanthamoeba

Philadelphia-Paul Karpecki, OD, FAAO, and Jill Autry, OD, RPh, shared clinical management pearls with attendees at the American Optometric Association’s Optometry’s Meeting.

This condition is more common in soft common contact lens wearers-75 to 90 percent of cases.

“Acanthamoeba presentation can mimic herpes simplex," says Dr. Karpecki.

“These patients are in a lot of pain, says Dr. Autry. “The corneal nerves are very inflamed.”

“Treatment is essentially pool chemicals we're throwing into the eye,” says Dr. Karpecki.

The hallmark is gelatinous presentation with disproportionate pain.

Pharmaceutical treatment includes:

• Biguanides

• Diamidines

• Antifungals

• Miconoazole, keraconozale

• Aminoglycosides

• Neomycin

“The only thing to prevent scarring is steroids,” says Dr. Karpecki.

Treatment plan includes:

• Epithelial debridement

• Pain management

• Cycloplegic, opiod, and cautious addition of steroidsODT