Common staining techniques for highlighting Acanthamoeba cysts

A 36-year-old woman returning from holiday in Portugal presented with bilateral ocular pain and acute visual loss. Eye examination revealed an inflammation in the anterior segment associated with corneal keratitis. During her trip, she wore contact lenses and rinsed the storage case using tap water. Corneal scrapings, contact lenses and cleaning solution from the case were inoculated onto agar plates supplemented with heat-inactivated bacteria. Bilateral Acanthamoeba keratitis was diagnosed, as microscopic examination of cultures from the last two samples revealed typical, spherical double-walled cystic structures (Fig. 1)