ISSN: 2459 - 1777 | E-ISSN 2587-0394
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Beyoglu Eye Journal Unilateral Painful Red Eye with Corneal Cysts Assessed with Corneal Confocal Microscopy: A Case Mimicking Acanthamoeba Keratitis [Beyoglu Eye J]
Beyoglu Eye J. 2020; 5(3): 234-237 | DOI: 10.14744/bej.2020.47965

Unilateral Painful Red Eye with Corneal Cysts Assessed with Corneal Confocal Microscopy: A Case Mimicking Acanthamoeba Keratitis

Aysun Sanal Doğan1, Canan Gürdal2, Emrah Utku Kabataş1, Naciye Kabataş1, Osman Çelikay1
1Department of Eye Diseases, Health Sciences University, Diskapi Training and Research Hospital, Ankara, Turkey
2Dünyagöz Hospitals, Ankara, Turkey

A 28-year-old woman with a history of trauma to her right eye 2 months prior reported experiencing a stinging sensation and tearing in the morning since the injury occurred and the need to occasionally use an eye patch. Three days before presentation she had been prescribed a therapeutic contact lens (CL) with the diagnosis of a corneal epithelial defect. She described significant pain despite the CL. There was a corneal lesion with haze at the base surrounded by corneal edema. Corneal confocal images revealed hyperreflective cystic lesions that suggested Acanthamoeba keratitis (AK). However, the lesion healed within 10 days and the results of cultures taken before the initiation of treatment proved to be negative. The history of trauma and CL wear, the presence of severe pain, corneal findings, and the confocal microscopy detection of cysts led to a suspicion of AK in a differential diagnosis, but the final diagnosis was recurrent epithelial erosion based on the negative culture results, quick response to treatment, and the possibility of similar confocal findings in a healing epithelium. Since AK may cause loss of vision, suspicion should require that samples be obtained for microbiological study and close follow-up of the clinical course until a final diagnosis can be achieved.

Keywords: Acanthamoeba keratitis, corneal confocal microscopy, corneal epithelium, recurrent epithelial erosion.

Aysun Sanal Doğan, Canan Gürdal, Emrah Utku Kabataş, Naciye Kabataş, Osman Çelikay. Unilateral Painful Red Eye with Corneal Cysts Assessed with Corneal Confocal Microscopy: A Case Mimicking Acanthamoeba Keratitis. Beyoglu Eye J. 2020; 5(3): 234-237

Corresponding Author: Aysun Sanal Doğan, Türkiye
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