To review challenges in the diagnosis and management of Acanthamoeba keratitis (AK), along with prognostic factors, in order to help ophthalmologists avoid misdiagnosis, protracted treatment periods, and long-term negative sequelae, with an overarching goal of improving patient outcomes and quality of life, we examined AK studies published between January 1998 and December 2019. All manuscripts describing clinical manifestations, diagnosis, treatment, prognosis, and challenges in short- and long-term management were included. The diagnosis of AK is often challenging. An increased time between symptom onset and the initiation of appropriate therapy is associated with poorer visual outcomes. The timely initiation of standardized antiamoebic therapies improves visual outcomes, decreases the duration of treatment, and reduces the chances of needing surgical intervention. In clinical practice, AK diagnosis is often missed or delayed, leading to poorer final visual outcomes and a negative impact on patient morbidity and quality of life.
Dry eye disease (DED) is one of the conditions that most commonly leads patients to visit an ophthalmologist. Fast and accurate diagnosis relieves patient discomfort and spares them from long-term effects on the ocular surface. Many tests used in the diagnosis of DED may be considered subjective as they rely on an experienced observer for image interpretation, resulting in variations in diagnosis. On one hand, the non-contact nature of the anterior segment optical coherence tomography (AS-OCT) device and its rapid image acquisition enable the measurement of the tear meniscus parameter without reflex tearing. On the other hand, an ocular hygrometer allows a rapid, safe, but also efficient, analysis and is associated with low costs and the repeatability of the procedure.