Acanthamoeba keratitis is a rare but sight threatening condition. A major problem is that the disease is difficult to diagnose and often mistaken for herpes infection in its early stages. We present an update in diagnostics with the presentation of five recent cases of Acanthamoeba keratitis where the use of confocal microscopy and PCR based DNA analysis of epithelial scrapings played a pivotal role. An early diagnose is crucial for achieving a successful outcome.