B60.13 Keratoconjunctivitis due to Acanthamoeba

Name of the Condition

• Keratoconjunctivitis due to Acanthamoeba

Summary

Keratoconjunctivitis due to Acanthamoeba is an infection of the cornea and conjunctiva caused by the free-living amoeba Acanthamoeba. This condition typically presents with eye inflammation and requires specific diagnostic methods to confirm the causative agent. Treatment focuses on antimicrobial therapy to address the infection and manage symptoms.

Causes

The infection is caused by Acanthamoeba species, which are found in environmental sources such as soil, water, and contact lens solutions. Transmission often occurs through exposure to contaminated water (e.g., swimming in lakes or using tap water to clean contact lenses) or contact with contaminated lens care products. The amoeba can invade the eye, leading to inflammation of the cornea and conjunctiva.

Risk Factors

• Use of contact lenses with improper hygiene or contaminated solutions.
• Exposure to contaminated water sources, such as swimming pools or tap water.
• Trauma to the eye or use of non-sterile eye care products.
• Weakened immune system, which may increase susceptibility to severe infection.

Symptoms

• Eye redness, irritation, or a gritty sensation.
• Excessive tearing or discharge.
• Blurred vision or sensitivity to light.
• Pain or discomfort in the affected eye.

Diagnosis

Diagnosis involves a thorough eye examination and laboratory testing, including corneal scrapings or biopsies to identify Acanthamoeba cysts or trophozoites. Clinical evaluation may also include slit-lamp examination to assess corneal involvement and rule out other causes of keratitis.

Treatment Options

Treatment typically involves topical antimicrobial agents, such as biguanides (e.g., polyhexamethylene biguanide) or diamidines (e.g., propamidine isethionate), to target the amoebic infection. In severe cases, systemic therapy may be considered. Pain management and supportive care, including lubricating eye drops, may also be necessary.

Prognosis and Follow-Up

Prognosis depends on the timeliness of diagnosis and treatment. Early intervention can improve outcomes, but delayed treatment may lead to corneal scarring or vision loss. Follow-up care is essential to monitor healing and adjust therapy as needed.

Complications

• Corneal scarring or perforation.
• Permanent vision impairment or blindness.
• Chronic eye pain or sensitivity.
• Secondary bacterial or fungal infections.

Lifestyle & Prevention

• Avoid using tap water to clean contact lenses or lens cases.
• Use sterile saline solutions and follow proper lens hygiene practices.
• Remove contact lenses before swimming or using hot tubs.
• Replace lens cases regularly and avoid contaminating them with water or soil.

When to Seek Professional Help

Seek immediate medical attention if you experience sudden eye pain, severe redness, vision changes, or discharge, especially if you wear contact lenses or have been exposed to contaminated water.

Tips for Medical Coders

Document the presence of keratoconjunctivitis and confirm the causative agent as Acanthamoeba to support the use of code B60.13. Include details about exposure history (e.g., contact lens use, water exposure) and diagnostic findings (e.g., corneal scrapings) to ensure accurate coding and clinical correlation.