Differentiation of acanthamoeba keratitis from other non-acanthamoeba keratitis: Risk factors and clinical features.

INTRODUCTION: Infectious Keratitis is one of the most common ocular emergencies seen by ophthalmologists. Our aim is to identify the risk factors and clinical features of Acanthamoeba Keratitis (AK). METHODS: This retrospective chart review study was conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, and included all the microbial keratitis cases, male and female patients of all ages. The main outcome is the differentiation between various microbial keratitis types. RESULTS: We included 134 consecutive eyes of 126 persons. We had 24 cases of acanthamoeba keratitis, 22 bacterial keratitis, 24 fungal keratitis, 32 herpetic keratitis, and 32 bacterial co-infection. Contact lens wear was found in 33 eyes (24.6%). Among acanthamoeba keratitis patients, 73% were ≤ 39 years of age, and 73% were females (P <0.001). Also, in AK cases, epithelial defect was found in all cases (100%), endothelial plaques were found in 18 eyes (69.2%), 12 cases had radial keratoneuritis (46.2%), and ring infiltrate was found in 53.8% of AK cases. CONCLUSIONS: We determined the factors that increase the risk of acanthamoeba infection and the clinical characteristics that help distinguish it from other types of microbial keratitis. Our findings suggest that younger females and patients who wear contact lenses are more likely to develop acanthamoeba keratitis. The occurrence of epitheliopathy, ring infiltrate, radial keratoneuritis, and endothelial plaques indicate the possibility of acanthamoeba infection. Promoting education on wearing contact lenses is essential to reduce the risk of acanthamoeba infection, as it is the most significant risk factor for this infection.

Transition to Ophthalmology Residency Program and the Role of Basic Science Course.

BACKGROUND: Residency training is a difficult and a highly stressful task, especially at the beginning of the training. The aim of this study is to assess the roles of the Basic Science Course (BSC) and independent preparation on the transition to ophthalmology residency in Saudi Arabia. METHODOLOGY: A cross-sectional study was conducted among ophthalmology program residents. The questionnaire was administered to 100 residents. Responses were analyzed for association using univariate analysis. RESULTS: Nearly 88% of residents were satisfied with their knowledge exposure during the BSC, while 67% thought that the majority of the BSC was dedicated to theoretical lectures. Surgical exposure was limited to attending surgeries for 38% of residents before joining residency programs, and 91% thought that there was little time dedicated for hands-on surgical skills training during the BSC, while only 11% thought that their surgical exposure was beneficial. Almost half of the beginning residents were accompanied by senior colleagues during their initial calls. More than 50% of residents felt that their transition to ophthalmology residency was more stressful than the transition to internship. CONCLUSION: The knowledge exposure from the BSC was helpful to facilitate the transition to ophthalmology residency program, especially for the ones who prepared well before. Improvement in surgical skills training should be aimed to further facilitate transition to ophthalmology residency program.