rbof Revista Brasileira de Oftalmologia Rev. bras.oftalmol. 0034-7280 1982-8551 Sociedade Brasileira de Oftalmologia 02207 10.37039/1982.8551.20260091 Image Corneal bright spots as a sign of Acanthamoeba keratitis Pontos brilhantes na córnea como sinal de ceratite por Acanthamoeba 0009-0009-9393-1253 Laaribi Nisrine 1 medical practice literature research writing 0009-0006-9577-4069 Reda Karim 1 supervision literature research Mohammed VI University of Sciences and Health Mohammed VI Faculty of Medicine Rabat Department of Ophthalmology Rabat Morocco Department of Ophthalmology, Mohammed VI Faculty of Medicine Rabat, Mohammed VI University of Sciences and Health, Rabat, Morocco. Nisrine Laaribi E-mail: nisrine.laaribi@gmail.com

no conflict of interest.

 30 09 2026 2026 85 e0091 22 12 2025 05 07 2026 Copyright ©2026 2026 The Author(s) All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License Keywords: Acanthamoeba keratitis Keratitis Corneal edema Contact lenses hydrophilic Ophthalmic solutions Descritores: Acanthamoeba keratitis Ceratite Edema de córnea Lentes de contato hidrofílicas Soluções oftálmicas Financial support: no financial support for this work.

A 26-year-old soft contact lens wearer presented with intense pain in the left eye for 24 hours. The patient endorsed using tap water for lens hygiene. The best-corrected visual acuity was 7/10 in the left eye. Slit-lamp examination of the left eye revealed conjunctival injection with mild central corneal edema. Multiple small white bright spots were defined in the area of corneal edema. The right eye examination was unremarkable. The patient was started on moxifloxacin and chlorhexidine 0.02% eyedrops every hour. Atropine 1% drop with physiological serum was started for 2 days. During the following day, the patient experienced decreased ocular pain. Microbiological examination from the contact lens were positive for Acanthamoeba spp. Moxifloxacin was stopped. The corneal examination was normal after 1-week of follow-up under chlorhexidine eyedrop. The presence of these bright spots in biomicroscopic examination can be a diagnostic biomarker for Acanthamoeba keratitis.(1)

Slit-lamp examination (X40) revealed mild central corneal edema with multiple small white bright spots.

no financial support for this work.

Department of Ophthalmology, Mohammed VI Faculty of Medicine Rabat, Mohammed VI University of Sciences and Health, Rabat, Morocco.

 Data availability statement:

the data that support the findings of this study are not openly available but are available from the corresponding author upon reasonable request.

 REFERENCES Ward MS Hastings JP Shmunes KM Ronquillo Y Hoopes PC Moshirfar M Atypical presentation of acanthamoeba keratitis resembling central toxic keratopathy Am J Ophthalmol Case Rep 2021 25 101243 101243 1 Ward MS, Hastings JP, Shmunes KM, Ronquillo Y, Hoopes PC, Moshirfar M. Atypical presentation of acanthamoeba keratitis resembling central toxic keratopathy. Am J Ophthalmol Case Rep. 2021;25:101243.