Culture negative confoscan positive acanthamoeba keratitis: a relentless course

Acanthamoeba keratitis is a protozoal infection of the eye, mainly due to the use of non-sterile solutions, like saline for disinfecting contact lenses. We report a case where delay in the diagnosis of acanthamoeba keratitis due to inadequate laboratory investigations and clinical management led to an excruciatingly painful course of the disease. The importance of non-invasive imaging techniques of confocal microscopy in the diagnosis of acanthamoeba keratitis, in the absence of positive culture reports, is highlighted in this case

Optical coherence tomographic view of persistent primary fetal vasculature

To report on the posterior segment changes in a patient with bilateral persistent primary fetal vasculature as detected by optical coherence tomography. An 18-year-old lady with poor vision, left esotropia and bilateral posterior polar cataract was found to have dysplasia of the macula in both the eyes. Fundus fluorescein angiography, optical coherence tomography, [A] scan biometry and genetic work up was performed as a part of investigation. There was increase in thickness of the macular area in both the eyes [450-500mm]. The left eye showed a [sail like] fold extending over macula, from nasal to temporal side. The tissue had the same sensitivity and thickness as inner the retinal layers [180-200mm]. There was no detectable nerve fibre layer in the macula of either eye. Fundus fluorescein angiography was normal in the right eye, and showed hyperfluorescence at the inferior pole of the disc in the left eye corresponding to the Bergmeister papilla. There was no staining of the membrane with the dye. Evaluation of the posterior segment is important in predicting the visual outcome in patients with any form of PFV. Optical coherence tomography is an adjuvant to direct visualization and aids in further delineating posterior segment changes seen in this condition