Severe Acanthamoeba sclerokeratitis in a non-contact lens wearer

Purpose: To report a case of severe Acanthamoeba sclerokeratitis. Methods: A 70-year-old male non-contact lens wearer was examined for severe pain in the left eye which began about 40 days after cataract surgery. In spite of a careful search, it required 6 weeks to detect Acanthamoeba. Systemic and topical fluconazol and miconazol did not help and the keratitis progressed into necrotic sclerokeratitis with protrusion of uveal tissue through the thin sclera. Results: Those findings slowly got worse before the Acanthamoeba sclerokeratitis resolved 6 months later with scar formation. Conclusion: We describe the terminal and cicatricial stages of Acanthamoeba keratitis, and report that the healing process can follow the terminal stage and the eye does not need to be enucleated.