Purpose: To report four cases of Acanthamoeba keratitis related to the overnight wearing of orthokeratology lenses.
Methods: Four patients had histories of overnight wearing of orthokeratology lenses when they presented with corneal ulcers. They had used a contact lens care system irregularly with tap water.
Results: The organism isolated by corneal scraping was Acanthamoeba. The patients were treated with polyhexamethylene biguanide (PHMB) and chlorhexidine, resulting in a resolution of ocular inflammation.
Conclusion: The risk of Acanthamoeba keratitis as a potential complication of overnight orthokeratology should be considered, especially in patients with over one-year duration of contact lens wearing. Careful contact lens management is needed and tap-water rinsing should be eliminated from the lens care regimen.
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