Acanthamoeba keratitis complicating orthokeratology

We report a case of a 48-year-old orthokeratology patient who developed a keratitis that had been initially managed as a herpes simplex keratitis. The ocular condition progressively worsened and a corneal biopsy was required to establish a diagnosis of acanthamoeba keratitis. Despite aggressive treatment, the patient was left with significant stromal scarring and a visual acuity of hand motion. This is the second published Case Report of acanthamoeba keratitis secondary to orthokeratology use in Canada. This report highlights the importance of a high index of suspicion when managing patients with keratitis secondary to orthokeratology, and the need for early and aggressive treatment.