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Purpose: The majority Acanthamoeba Keratitis (AK) cases resolve within 3-6 months with minimal vision loss, however others have a protracted disease course, severe inflammatory complications and debilitating vision loss. Determining characteristics of AK patients with poor outcomes is key to better management.

Methods: A retrospective records review of AK cases treated at Moorfields Eye Hospital between 1991-2012 was conducted. AK cases with poor outcomes were defined as those having one or more of the following features: corneal perforation, keratoplasty, other ocular surgery (except biopsy), duration of antiamoebic treatment (AAT) of 10.5 months or more (based on 75th percentile of whole sample) and final VA≤ 20/80 attributed to AK. Severe inflammatory complications were defined as scleritis and/or stromal ring infiltrates.

Results: Those with poor outcomes were more likely to be older (median 38 vs …