Cornea & Conjunctiva · NEET PG Preparation Ophthalmology
A 24-year-old contact lens wearer presents with severe eye pain, photophobia, and a foreign body sensation. Examination reveals a ring-shaped corneal…
Practice question from Cornea & Conjunctiva (NEET PG Preparation Ophthalmology), with the correct answer and a step-by-step solution.
hard · MCQ · Q-8B772C
A 24-year-old contact lens wearer presents with severe eye pain, photophobia, and a foreign body sensation. Examination reveals a ring-shaped corneal stromal infiltrate and a painful epithelial defect. Confocal microscopy shows highly reflective double-walled cysts. What is the most appropriate management?
- A.Topical Natamycin 5%
- B.Topical Polyhexamethylene biguanide (PHMB) 0.02% with Chlorhexidine 0.02%Correct answer
- C.Topical Valganciclovir
- D.Intravitreal Amphotericin B
Solution
The clinical presentation of a ring infiltrate, severe pain out of proportion to signs, and a contact lens history in a young patient strongly points to Acanthamoeba keratitis. Confocal microscopy demonstrating double-walled cysts confirms the diagnosis. The treatment of choice includes biguanides (PHMB 0.02% or chlorhexidine 0.02%) along with diamidines (propamidine isethionate).
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