Corneal Exophytic Mass Secondary To Acanthamoeba Keratitis- Case Report.

To report an unusual case of Acanthamoeba presenting as a protuberant mass over the cornea.

1.Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

2. Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice,

Poland                                                                                                                      

A 58-year-old male patient referred to our center with a case of corneal tumor, was examined in the department and found to have a central mass over the cornea with deep vessels peripherally. He was being treated for a possible microbial/viral keratitis 4 years earlier in other hospital. The left eye was blind due to glaucoma neuropathy since 10 years. The mass was removed and Amniotic Membrane was transplanted. The tissue was subjected to histopathological investigation. Histopathological analysis of the epicorneal mass and part superficial cornea revealed it to be an active acanthamoeaba -mass full of trophozoites and cysts. The topical therapy was started  with propamidine 0,1% eye drops and continued for a prolonged period, tapering off over 12 months. The confoscan exam was done 6 months after surgery. At present, visible non-clearing, vascularized corneal edema with scars.

Acanthamoeba should be considered in the differential diagnosis of any unexplained keratitis, even those of long duration. Surgical intervention and appropriate antiprotozoal therapy are key to a successful outcome. The diagnosis of AK is problematic and it is often misdiagnosed as bacterial, viral or fungal keratitis