Acanthamoeba Keratitis May Reduce Vision-Related Quality of Life

Close-up of keratitis
Close-up of keratitis (corneal inflammation) in the right eye caused by an infection of Acanthamoeba, a free-living pathogenic ameba. The condition is often associated with contactlens use.
Clinicians should consider referring patients with AK to mental health professionals for rehabilitative support and counseling, a study suggests.

Acanthamoeba keratitis (AK) has a detrimental effect on vision-related quality of life (VRQOL) by approximately 60%, according to research published in Cornea.

Researchers investigated the association between AK and low VRQOL in an observational, case-control study of  120 participants. The study sample consisted of individuals with AK (n=61, mean age 39±17 years, 56% women) and a healthy contact lens wearing control group (n=59, mean age 46±15 years, 78% women). Investigators administered the Impact of Vision Impairment questionnaire to all patients and collected data on age, sex, race, income, and education level. They also classified those in the AK group as having a ‘good’ or ‘poor’ outcome with poor defined as having 1 or more of the following features: last recorded VA of 20/80 or worse, active treatment of 12.6 months or more (75th percentile) or perforation, having undergone keratoplasty, or having undergone other surgery (excluding biopsy).

Patients undergoing treatment for AK reported lower VRQOL compared with the control group in the domains of reading (59.60% reduction), mobility (59.80% reduction), and emotional (66.20% reduction).

Patients with good disease outcomes had higher VRQOL compared with patients with poor disease outcomes.

Those self-reporting as British White scored lower on the VRQOL assessment compared with individuals of other ethnic groups. Men’s VRQOL scores surpassed women’s scores. Patients with high incomes had better reading and mobility VRQOL scores compared with individuals with lower income. Patients with higher education reported better emotional VRQOL scores compared with those with less formal schooling.

Researchers highlight the importance of hygiene awareness and adherence to clinical instructions for cleaning and storing contact lenses:. “This is particularly pertinent because many children younger than age 10 are beginning to wear CLs to stem the tide of increasing myopia. Balancing the risks of CL wear in youth, such as development of AK, compared with vision loss in older age due to high myopia is imperative.”

Limitations of the study included a failure to collect clinical data at time of survey and inability to match the demographics of the control group to the treatment group. 

Reference

Carnt NA, Man REK, Fenwick EK, et al. Impact of Acanthamoeba keratitis on the vision-related quality of life of contact lens wearers. Cornea. 2022;41(2):206-210. doi: 10.1097/ICO.0000000000002901