Lens wear was ceased and the patient was commenced on gutt ciprofloxacin 0.3% hourly by day and chloramphenicol ointment at night by the Optometrist, with a provisional diagnosis of bacterial keratitis. This case highlights Acanthamoeba keratitis as a rare but serious complication of orthokeratology lens wear and demonstrates the associated diagnostic challenges. Keywords: Acanthamoeba; contact lenses; keratitis; orthokeratology; paediatric ophthalmology EN Acanthamoeba contact lenses keratitis orthokeratology paediatric ophthalmology 800 802 3 09/07/23 20230901 NES 230901 Introduction We present a case of a 13-year-old female orthokeratology lens wearer who suffered a potentially blinding I Acanthamoeba i keratitis, despite being generally compliant with lens care protocols. [Extracted from the article]