title: Contact Lens-Related Acanthamoeba Keratitis and Accompanying Dacryoadenitis.
abstract: OBJECTIVE
  In this study, by presenting four cases, we aimed to discuss the clinical presentation, diagnosis, therapy, and methods for prevention of Acanthamoeba keratitis (AK) and to emphasize that inflammatory dacryoadenitis can be seen together with it.
  
  
  METHODS
  This is a retrospective case series of four eyes of four wearers of hydrophilic soft contact lenses who developed AK. The diagnosis was based on clinical signs, disease course, and confocal microscopy results. In cases with dacryoadenitis, in addition to clinical findings, magnetic resonance imaging was used to establish the diagnosis.
  
  
  RESULTS
  All of the cases were using their contact lenses without supervision of an ophthalmologist under inappropriate conditions such as swimming in a pool and during steam bath. The diagnosis was established, and the treatment was performed within the standard protocol for AK. Two of the patients had low visual acuity at the level of counting fingers with corneal scar, cataract, and glaucoma, whereas the other two healed with fewer complications and achieved better vision. Two of the 4 cases (50%) presented with dacryoadenitis accompanying the AK. Lacrimal gland swelling improved in conjunction with symptoms of keratitis without specific treatment for dacryoadenitis in these two cases.
  
  
  CONCLUSIONS
  Despite the improvements in diagnostic tests and treatment strategies for AK, the role of prevention becomes apparent because of the bad prognosis of this serious complication; thus, contact lens wearers should be aware of the importance of using lenses under ophthalmologist's supervision. In addition, we would like to emphasize that AK may be frequently associated with lacrimal gland inflammation.
authors.affiliation: Department of Ophthalmology (T.S.), Kadıköy Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey; Department of Ophthalmology (S.A.K., A.A., S.F.A., S.A.), Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey; and Department of Ophthalmology (M.I.), Hacettepe University, Ankara, Turkey.
authors.forename: Tomris
authors.initials: T
authors.lastname: Sengor
authors.forename: Sevda A
authors.initials: SA
authors.lastname: Kurna
authors.forename: Ahmet
authors.initials: A
authors.lastname: Altun
authors.forename: Murat
authors.initials: M
authors.lastname: Irkec
authors.forename: Suat F
authors.initials: SF
authors.lastname: Aki
authors.forename: Sibel
authors.initials: S
authors.lastname: Aksoy
mesh_terms: D015823:Acanthamoeba Keratitis / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D000328:Adult; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003607:Dacryocystitis / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult