Acanthamoeba Keratitis;

A Clearer Vision for the

Future

Professor John Coia and Dr. Claire Alexander

Scottish Parasite Diagnostic and Reference Laboratory

Glasgow Royal Infirmary

•Caused by Acanthamoeba species

•Associated with contact lens use

•3.7 million contact lens wearers in

the UK

•Incidence in Scotland 149 cases per

million?

Acanthamoeba Keratitis

Daily Mail May 2015:

“A parasite from my contact lens is gnawing into my eyeball: The

gruesome truth about a scarily common bug…….”

Metro Newspaper Oct 2015:

“Woman nearly has her eye eaten from the inside by horrible

parasite…..”

Recent Media Awareness

Early phase – responds to antimicrobials

Advanced phase – requires surgery

Clinical Presentation

Issues

Symptoms

mimic

other diseases

Inaccurate

diagnosis

Inappropriate

treatment

Significant

NHS costs

Ineffective

laboratory

testing

Delayed

diagnosis /

Poor prognosis

STEP 2

Explore

Testing

Options

STEP 3

Engage

with

Reference

Lab Staff

STEP 4

Develop

Assay

STEP 5

Implement

STEP 1

Engage

with users

& HPS

What Next?

Review•Audit

•Phone positive findings

Adapt•Patient information

leaflet

•Staff sampling leaflet

•Collection tubes

Share•Workshops

•Training others

•Update

Network•Local, national,

international meetings

Sustainable Commitment

Improvements

•Improved quality of patient care

•Significant cost savings

•Improved epidemiological data

•Greater awareness and understanding of the disease

•UK-wide testing

•In-depth molecular profiling

•Inclusion of other ocular pathogens

Vision for Future

Team photo!

Scottish Microbiology Reference Laboratories, Glasgow

Diagnostic Directorate, Greater Glasgow and Clyde NHS

Health Protection Scotland

Scottish NHS Ophthalmology Departments and Microbiology

Laboratories

Scottish Virology Microbiology Network

Funding support was provided through NHS National Services Scotland

Acknowledgements