title: Bilateral acanthamoeba keratitis after orthokeratology.
abstract: OBJECTIVE
  To report bilateral Acanthamoeba keratitis after wearing an overnight reverse geometric contact lens for 5 days.
  
  
  METHODS
  Case report and review of the medical literature
  
  
  RESULTS
  A 22-year-old woman developed bilateral corneal ulcers during orthokeratology. A slit-lamp examination showed round epithelial abrasion, radial infiltration, and disciform keratitis in both corneas. Visual acuity OD was hand motion and OS was counting fingers. Bilateral Acanthamoeba keratitis was diagnosed by culture by using non-nutrient agar overlaid with viable Escherichia coli. Small, round, and double-walled cysts were observed in non-nutrient agar under an inverted phase contrast microscope. Topical 0.02% polyhexamethylene biguanide, Cravit (0.5% levofloxacin), and Tobra (0.5% tobramycin) were administered. After 1 month of treatment, the corneal ulcer had healed, and the patient's best-corrected visual acuity was 20/100 OD and 20/25 OS.
  
  
  CONCLUSIONS
  Acanthamoeba keratitis can simultaneously affect both eyes during overnight orthokeratology.
authors.affiliation: Department of Ophthalmology and Visual Science, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Kim
authors.forename: Man Soo
authors.initials: MS
authors.lastname: Kim
mesh_terms: D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D001645:Biguanides / Q000627:therapeutic use; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D007839:Functional Laterality; D006801:Humans; D064704:Levofloxacin; D015242:Ofloxacin / Q000627:therapeutic use; D054158:Orthokeratologic Procedures / Q000009:adverse effects*; D014031:Tobramycin / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D001645:Biguanides; C031233:polihexanide; D064704:Levofloxacin; D015242:Ofloxacin; D014031:Tobramycin