We examined and treated six patients with acanthamoeba keratitis associated with contact lens wear from 1981 to 1988. Five patients were treated with topical neomycin-polymyxin B-gramicidin (Neosporin) and propamidine isethionate (Brolene) drops. The patients were followed up for an average of 32 months (range 16-75 months). Two patients underwent penetrating keratoplasty at 22 and 26 months after the onset of symptoms and have maintained clear grafts with no evidence of recurrence. In four patients corneal infiltrates cleared on topical medication. All six patients have 6/6 best corrected vision. Early diagnosis and medical treatment alone can result in resolution of corneal infiltrates due to acanthamoebae. With this initial therapy we have had no treatment failures.