DR. KALPANA BAISHYA

Dr.Gogoi Rajendra Nath

Abstract

A 80 years old male, hailing from rural area presented with severe pain, redness, watering, photophobia and decreased vision in the R/E for 1month. He had history of similar episode 4 months back and diagnosed as bacterial corneal ulcer with slough. He received topical antibiotics and advised to apply bandage contact lens, had no history of injury with vegetative matter or bathing in ponds. O/E, BCVA is 1m. the corneal ulcer was 3*4mm centrally with irregular surface, along with whitish dense infiltration, associated with grooved shaped corneal melting. Corneal scrapings were sent for gram stain and KOH, showed cyst-like structure (Acanthamoeba) with plenty of pus cells and gram positive cocci. The progressive nature of corneal infiltrate, epithelial defect along with severe pain maybe due to nerve involvement and non-responsive to treatment, suggestive of Acanthamoeba keratitis. Now, the patient is well responding to topical antibiotic, antifungal and antibiotic eye ointment.