Acanthamoeba Keratitis in Non-Contact Lens Wearers

To the Editor.

—We read the timely article by Sharma and coworkers¹of nine cases ofAcanthamoebakeratitis in non-contact lens wearers in India during a 2-year period. We fully agree with the authors that the diagnosis ofAcanthamoebakeratitis 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.²There is very little reason to believeAcanthamoebakeratitis 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 ofAcanthamoebakeratitis 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-provenAcanthamoebaulcerative