To the Editor.
—We read the timely article by Sharma and coworkers1 of nine cases of Acanthamoeba keratitis in non-contact lens wearers in India during a 2-year period. We fully agree with the authors that the diagnosis of Acanthamoeba keratitis may be unduly delayed if the clinician fails to consider risk factors other than contact lens wear, ie, foreign-body injuries to the cornea and contact with contaminated water.2 There is very little reason to believe Acanthamoeba keratitis in non-contact lens wearers is a new phenomenon; it is more likely that many of these cases were missed in the past. Only now are we able to appreciate the true incidence of Acanthamoeba keratitis in non-contact lens wearers, owing to a combination of heightened awareness, better clinical diagnostic criteria, and improved laboratory studies.See also p 471.In our own 2-year experience, three of 12 cases of culture-proven Acanthamoeba ulcerative
Spaeth GL, Chang PCT, Soong HK. Acanthamoeba Keratitis in Non-Contact Lens Wearers. Arch Ophthalmol. 1991;109(4):463–464. doi:10.1001/archopht.1991.01080040023004
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