EyeTools Optometry Skills

64. A case of contact lens induced acanthamoeba keratitis?

A 30-year-old gas permeable contact lens wearer has developed a painful red eye after going swimming in a lake whilst wearing his contact lenses. He is light sensitive and there is a lot of tearing. What is going on?

Swimming in a lake whilst wearing contact lenses is a recipe for disaster; an ocular catastrophe is very very likely. What do I mean by ocular catastrophe? The worst possible. Permanent blindness. Removal of an eye.

Sounds very much like acanthamoeba keratitis; a rare infection caused by a microscopic, free-living amoeba (a single-celled living organism). Acanthamoeba amoebas are very common in nature found in bodies of water (for example, lakes and oceans), soil, and air.

Blurred vision is another symptom.

Encouraging patients, who wear contact lenses, to adhere to the following will reduce the chances of ocular catastrophe:

Wear and replace contact lenses according to the advised schedule.

Remove contact lenses before any possible contact with water, including showering, using a hot tub, or swimming.

Wash hands with soap and water and dry before handling contact lenses.

Clean contact lenses according to instructions

Never reuse or top off old solution. Use fresh cleaning or disinfecting solution each time lenses are cleaned and stored.

Never use saline solution or rewetting drops to disinfect lenses.

Clean, rub and rinse lenses each time they are removed your lenses.

Store reusable lenses in the proper storage case.

Clean storage cases by rubbing and rinsing with sterile contact lens solution (never use tap water), empty and leave open to dry after each use.

Replace storage cases every three months.


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