title: Dacryoadenitis and extraocular muscle inflammation associated with contact lens-related Acanthamoeba keratitis: A case report and review of the literature.
abstract: The present report discusses a new case of dacryoadenitis with extraocular muscle inflammation associated with Acanthamoeba keratitis (AK) in a contact lens wearer. A 41-year-old male, who has worn silicone hydrogel contact lenses on an extended basis for about 10 years, attended with the complaints of vision disturbance, hyperemia, and pain in his right eye. His history revealed that 1.5 month ago, he had been diagnosed with allergic conjunctivitis and had used steroid eye drops. Biomicroscopic examination revealed eyelid edema, chemosis, and ring infiltration, radial keratoneuritis and an epithelial defect in the cornea. Magnetic resonance imaging demonstrated enlarged lacrimal gland with edematous changes consistent with inflammation due to dacryoadenitis. There were also thickening and edema of the right superior oblique and lateral rectus muscle. The treatment protocol for AK was applied with no specific treatment for dacryoadenitis. After 4 months of the treatment, dacryoadenitis and keratitis regressed. Dacryoadenitis and extraocular muscle inflammation may accompany AK more frequently than expected and previously known. The evaluation of the lacrimal gland and extraocular muscles in presence of AK might be beneficial for understanding better the exact clinical picture and course of the keratitis.
authors.affiliation: a Department of Ophthalmology , Bilim University, Florence Nightingale Hospital , Istanbul , Turkey.
authors.forename: Tomris
authors.initials: T
authors.lastname: Sengor
authors.affiliation: a Department of Ophthalmology , Bilim University, Florence Nightingale Hospital , Istanbul , Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Yuzbasioglu
authors.affiliation: b Clinic of Ophthalmology , Fatih Sultan Mehmet Education and Research Hospital , Istanbul , Turkey.
authors.forename: Sevda
authors.initials: S
authors.lastname: Aydın Kurna
authors.affiliation: c Department of Ophthalmology , Hacettepe University , Ankara , Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Irkec
authors.affiliation: b Clinic of Ophthalmology , Fatih Sultan Mehmet Education and Research Hospital , Istanbul , Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Altun
authors.affiliation: b Clinic of Ophthalmology , Fatih Sultan Mehmet Education and Research Hospital , Istanbul , Turkey.
authors.forename: Kubra
authors.initials: K
authors.lastname: Kökcen
authors.affiliation: a Department of Ophthalmology , Bilim University, Florence Nightingale Hospital , Istanbul , Turkey.
authors.forename: Nazli Gul
authors.initials: NG
authors.lastname: Yalcin
mesh_terms: D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001550:Benzamidines / Q000627:therapeutic use; D001645:Biguanides / Q000627:therapeutic use; D003261:Contact Lenses / Q000469:parasitology*; D003607:Dacryocystitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D004359:Drug Therapy, Combination; D015822:Eye Infections, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D024841:Fluoroquinolones / Q000627:therapeutic use; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018613:Microscopy, Confocal; D000077266:Moxifloxacin; D009801:Oculomotor Muscles / Q000469:parasitology*; D055622:Orbital Myositis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*
chemical_list: D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D001550:Benzamidines; D001645:Biguanides; D024841:Fluoroquinolones; D005839:Gentamicins; C031233:polihexanide; C046651:propamidine isethionate; D000077266:Moxifloxacin
keywords: Acanthamoeba; dacryoadenitis; extraocular muscle inflammation; keratitis