Posters

Development of scleromalacia with ectasia in acanthamoeba keratitis

Poster Details

First Author: O. Giasin UNITED KINGDOM

Co Author(s):    T. Young-Zvandasara   M. Elmi   M. Muhtaseb              

Abstract Details

Purpose:

A case report to describe the sudden development of unilateral Scleromalacia with ectasia in Acanthamoeba Keratitis without a significant preceding Scleritis in a 79 year old soft contact lens wearer. There is no other reported case in the literature of this occurrence.

Setting:

Ophthalmology unit

Methods:

Case report

Results:

The Patient presented to our eye unit with clinical findings suggestive of contact lens related Keratitis and treatment for this was initially effective. A later finding was the development of a corneal ring abscess, raising the suspicion of Acanthamoeba keratitis with a superadded bacterial infection. Acanthamoeba was subsequently confirmed on corneal biopsy and confocal microscopy. Whilst on long term treatment, the patient developed Scleromalacia with ectasia at the 12 o'clock position prior to this an episode of raised Intraocular pressure had been treated topically. In this case there were no significant symptoms or signs of Scleritis at any point immediately before the abrupt development of Scleromalacia.

Conclusions:

We hypothesise the Scleromalacia and secondary ectasia formation are due to a combination of low grade inflammation of the sclera resulting in scleral thinning and raised intraocular pressure and the eventual protrusion. Our patient is also of an older age group for acquiring acanthamoeba keratitis; it seems logical to assume the older age group will inherently have a thinner or structurally abnormal sclera although studies have shown the sclera permeability or ultrastructure do not alter with age. The case highlights an unusual sequelae of acanthamoeba keratitis and the diagnostic difficulties

Financial Disclosure:

NONE