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المستخلص
Acanthamoeba keratitis was first described 30 years ago.It is a sight-threatening, severe and painful corneal infection, caused by different subspecies of Acanthamoeba, with a prolonged course featuring remissions and exacerbations.
Acanthamoeba is a free living amoeba that thrives in soil and water environments. Acanthamoeba species live in 2 forms, the active form known as the trophozoite and the nonmotile cyst form. They enter the cystic stage when environmental conditions are difficult.
Ocular infection has been increasingly recognized in association with various causes of disturbance of ocular surface epithelium, in particular, with contact lens wear.
The pathophysiology of this infection involves an intricate series of sequential events that includes the production of several pathogenic proteases that degrade basement membranes and induce cytolysis and apoptosis of the cellular elements of the cornea, culminating in dissolution of the collagenous corneal stroma.
Variability is the most striking fact in the clinical picture of patients presenting with Acanthamoeba keratitis. It usually starts as an unilateral red eye with epiphora, foreign body sensation, pain and photophobia.