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Persistent acanthamoeba keratitis in a non-contact lens wearer following exposure to bird seed dust
  1. P P Syam,
  2. R Narendran,
  3. J van der Hoek
  1. Department of Ophthalmology, Scarborough Hospital, Woodlands Drive, Scarborough, YO12 6QL, UK
  1. Correspondence to: Mr P P Syam Department of Ophthalmology, Peterborough Hospital, Thorpe Road, Peterborough PE3 6DA, UK;

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Acanthamoeba keratitis is a serious and vision threatening disease. It is commonly associated with contact lens wear (up to 93%).1 Early diagnosis and treatment are essential to improve the visual outcome.2 Devastating ocular damage can be attributed to various factors such as misdiagnosis,3 incorrect treatment, excessive topical steroid before diagnosis,4 and resistance.5

Acanthamoeba keratitis in non-contact lens wearers is rare and poses a diagnostic challenge. We present a case of acanthamoeba keratitis in a non-contact lens wearer following accidental exposure to bird seed dust. The strain of acanthamoeba obtained from this patient appeared to show in vivo and in vitro resistance to poly(hexamethylene biguanide, PHMB) and chlorhexidine after a good clinical response initially.


A 57 year male patient presented with pain, blurring of vision, and photophobia of his left eye. Two weeks before the presentation he had …

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