Successful treatment of Acanthamoeba keratitis without anti-amoebic agents.

Dear Editor, Acanthamoeba species are opportunistic pathogens that can cause life-threatening diseases in the immunocompromised host. In healthy individuals, Acanthamoeba can cause ulcerating keratitis, which is associated with the use of improperly sterilised contact lenses, trauma or washing with contaminated water.1 Reports have shown that the defenses of a healthy host seemed sufficient to prevent systemic Acanthamoeba infection.2 The first-line treatment of Acanthamoeba keratitis is topical therapy with biguanides such as polyhexamethylene biguanide or in combination with diamidenes such as propamidine, aminoglycosides and imidazoles. However, these drops are not always available and chronic use is associated with significant ocular surface toxicity.3