Diagnosis of acanthamoeba keratitis--a report of four cases and review of literature.

Acanthamoeba keratitis is not reported often in India. We reported the first case diagnosed in this country a year back. In this communication, four more cases of Acanthamoeba keratitis diagnosed since then are being reported along with a brief review of literature. Diagnosis in all these patients was based on observation of acanthamoeba cysts in 10% KOH wet mount of corneal ulcer scrapings and subsequent culture. The characteristic ring infiltration of cornea was seen in all of them. All cases were treated medically with the available antiamoebic drugs (Miconazole, Neosporin, Ketoconazole and Metronidazole) in different combinations. Only one out of four, responded with complete healing of the ulcer. Acanthamoeba keratitis is probably not as uncommon in India as it is thought to be. With increased awareness and performance of minimal laboratory tests the condition may be diagnosed more often.