Purpose: To evaluate the outcome of Acanthamoeba keratitis with respect to the delay in diagnosis Methods: A retrospective review of the records of 14 patient s treated for A canthamoeba keratitis was carried out. Delay in diagnosis was co rrelated with risk factors, clinical presentation, method of diagnosis, final vi sual acuity and need for penetrating keratoplasty. Results: Based on the time in terval between the first symptoms and the diagnosis of Acanthamoeba keratitis, i t appeared that patients could be divided into two groups: an early treatment gr oup (group I), consisting of six patients treated within 18 days of onset of sym ptoms, and a late treatment group (group II), composed of eight patients treated beyond that time. There were no statistically significant differences between t he two groups as far as risk factors, clinical presentation, accuracy of diagnos iof and method of diagnosis were concerned, although more extensive and deeper c orneal involvement was noted in group II. Improvement in visual acuity following medical therapy was seen in all six patients in the early group and in three (3 7%) of the eight patients in the late group. One patient in group I needed urge nt penetrating keratoplasty for corneal necrosis. In group II, two patients unde rwent penetrating keratoplasty chaud to prevent corneal perforation and three patients needed penetrating keratoplasty to restore functional visual acuity. Co nclusion: A diagnostic delay of less than 18 days between onset of symptoms and start of anti-amoebic treatment results in a better final VA after medical trea tment and obviates the need for urgent and elective penetrating keratoplasty. Purpose: To evaluate the outcome of Acanthamoeba keratitis with respect to the delay in diagnosis Methods: A retrospective review of the records of 14 patient s treated for A canthamoeba keratitis was carried out. Delay in diagnosis was co-correlated with risk factors, clinical presentation, method of diagnosis, final vi sual acuity and need for penetrating keratoplasty. Results: Based on the time in terval between the first symptoms and the diagnosis of Acanthamoeba keratitis, it has had that patients could be divided into two groups: an early treatment gr oup ( composed of six patients treated within 18 days of onset of sym ptoms, and a late treatment group (group II), composed of eight patients treated beyond that time. There were no statistically significant differences between t he two groups as far as risk factors, clinical presentation, accuracy of diagnostics and method of diagnosis were concerned, although more extensive and deeper c orneal involvement was noted in group II. Improvement in visual acuity following medical therapy was seen in all six patients in the early group and in three (37%) of the eight patients in the late group. One patient in group I needed urge nt penetrating keratoplasty for corneal necrosis . In group II, two patients unde rwent penetrating keratoplasty chaud to prevent corneal perforation and three patients needed penetrating keratoplasty to restore functional visual acuity. Co nclusion: A diagnostic delay of less than 18 days between onset of symptoms and start of anti-amoebic treatment results in a better final VA after medical trea tment and obviates the need for urgent and elective penetrating keratoplasty.