A soft contact lens wearer developed pain and itching of the eye and showed a reticular pattern on the corneal epithelium. The cause could be –

Reticular patter of keratitis in a contact lens wearer is seen in Acanthamoeba. Initially the Acanthamoeba keratitis shows typical reticular pattern due to radial keratoneuritis (Radial perineuritis), i.e. inflitrates along corneal nerves. Due to this, the pain is very severe (neurological due to perineuritis) which is out of proportion to the degree of inflammation. Later, reticular superficial keratitis advanced to ring-shaped lesion in central or paracentral region.