Bilateral acanthamoeba keratitis.

Purpose: To determine the prevalence and characteristics of binocular involvement among patients with Acanthamoeba keratitis.

Design: Retrospective case series.

Methods: Risk factors and outcomes of bilateral infection were explored among consecutive cases of Acanthamoeba keratitis diagnosed at a single institution from 1997 through mid 2007.

Results: Fifty eyes were confirmed to have Acanthamoeba keratitis by microbiologic or histopathologic testing; two-thirds occurred during a regional outbreak beginning in 2004. Five (11%) of 45 patients had infection of both eyes, including three with concurrent involvement and two with successive disease of the contralateral cornea. Three binocularly infected patients used soft contact lenses, and two wore rigid gas-permeable lenses. Nine of 10 eyes achieved visual acuity of 20/30 or better after antiamebic therapy.

Conclusions: Bilateral Acanthamoeba keratitis is an infectious complication of contact lens wear. With laboratory confirmation, vision often can be restored with medical therapy.