Two months later, she was seen at our center. She had significant pain and her visual acuity was hand motions. Examination revealed multiple epithelial defects and diffuse anterior keratitis with a ring infiltrate. Confocal microscopy revealed probable Acanthamoeba cysts. Corneal scrapings were performed for culture. Treatment with trifluridine, prednisolone, and famciclovir was discontinued, and treatment with propamidine isethionate, polyhexymethylene biguanide, chlorhexidine gluconate, neomycin sulfate, and atropine sulfate eyedrops was started.