Acanthamoeba keratitis.

1. Acanthamoeba keratitis is an uncommon but increasingly prevalent infection with the potential to cause severe ocular damage. Acanthamoeba is a nonflagellated free-living amoeba that is ubiquitous in the environment. The most common type is A castellani, but A polyphagia, A rhysodes, A culbertson, and A hatchetti have been isolated from infected eyes. 2. Clinical features include foreign body sensation, blurred vision, tearing, and photophobia. There is minimal pain in the early stages of infection, but severe pain is a manifestation of the advanced stages of the disease. 3. The incidence of Acanthamoeba keratitis appears to be decreasing because of increased awareness, but education emphasizing proper lens sterilization is essential and should be carried out when contact lenses are first dispensed.