title: Bilateral Acanthamoeba keratitis in an experienced two-weekly disposable contact lens wearer.
abstract: OBJECTIVE
  To present a case of bilateral Acanthamoeba keratitis in a patient who stored both contact lenses in the same storage case.
  
  
  METHODS
  The case report of a 44-year-old female contact lens wearer who developed bilateral culture-positive Acanthamoeba keratitis. Although an experienced contact lens user for many years, she admitted to occasionally rinsing her dual contact lens case in tap water and leaving it to air dry. She was successfully treated with intensive topical polyhexamethyl biguanide and propamide isethionate in conjunction with a mydriatic agent, topical ofloxacin, and oral flurbiprofen.
  
  
  RESULTS
  The Acanthamoeba keratitis resolved without sequelae. After 6 months, the patient had a visual acuity of 20/20 in each eye.
  
  
  CONCLUSIONS
  Although bilateral Acanthamoeba keratitis is rare, it is essential that the patient is properly educated in contact lens hygiene and disinfection. Regular contact lens follow-up of patients is essential, and lens storage and disinfection techniques must be reviewed with the patient. The use of single-use contact lens storage cases may be advantageous in reducing the incidence of bilateral disease after case contamination.
authors.affiliation: Epsom and St. Helier University Hospitals, Surrey, United Kingdom. georgevoyatzis@gmail.com
authors.forename: George
authors.initials: G
authors.lastname: Voyatzis
authors.forename: Andrena
authors.initials: A
authors.lastname: McElvanney
mesh_terms: D000048:Acanthamoeba / Q000302:isolation & purification*; D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000208:Acute Disease; D000328:Adult; D000563:Amebicides / Q000008:administration & dosage; D000818:Animals; D018639:Contact Lens Solutions; D003261:Contact Lenses / Q000009:adverse effects* / Q000469:parasitology; D003937:Diagnosis, Differential; D004209:Disposable Equipment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009883:Ophthalmic Solutions / Q000008:administration & dosage
chemical_list: D000563:Amebicides; D018639:Contact Lens Solutions; D009883:Ophthalmic Solutions