Amoebic keratitis in Iran (1997-2007)

Background: amoebic keratitis introduced as a painful corneal infection which sometimes lead to poor vision and blindness.the main goal of this study was to report amoebic keratitis during ten years from 1997-2007 in patients who was suspectedto have amoebic keratitis and referred to parasitology laboratory, school of public health, tehran university ofmedical sciences, iran. other aim was to assess the major risk factor for developing this sight-threatening disease.comparison of lens culture and corneal scrapes culture also was performed.methods: during 1997-2007, 142 patients referred to dept. of medical parasitology, school of public health, tehran universityof medical sciences, iran. details of each patient such as age, sex, history of contact lens wear, type of contact lens,clinical symptoms were recorded in questioners. keratitis was diagnosed on the basis of culture of lenses and/or cornealscrapes on non-nutrient agar overlaid with escherichia coli and direct microscopy of lenses and/or corneal scrapes.results: among 142 patients, 49 (34.5%) had amoebic keratitis. 73.46% of these patients were from tehran but there werea few cases from other cities. the commonest age was between 15-25 yr (75.5%) and more female (37:12) were identifiedthen male. it is worth to mention that 44 patients (89.79%) were contact lens wearers who among them 41 patients (93.18%)wore soft contact lens and only three patients suffer from amoebic keratitis because of wearing hard contact lens. otherfinding of this study demonstrated that the most common sign of the patients was severe pain combined with photophobia.conclusion: this study indicates that acanthamoeba keratitis continue to rise in iran. this is due to increase frequency oflens wearers as well as consideration of ophthalmologist to acanthamoeba as an agent of keratitis and improvement of laboratorymethods. another finding of this research was the confirmation of soft contact lens as a major risk factor. it is recommendedto educate contact lens wearers for regular disinfection. besides, culture of corneal scrapes was negative in mostof cases, so lens culture were performed which had a much better result.