Whorl keratopathy is associated with which medication?

• A. Amiodarone
• B. Digoxin
• C. Warfarin
• D. Clonidine

Answer: (A)

Whorl keratopathy, or corneal verticillata, happens when certain systemic drugs accumulate in the corneal epithelium as lipophilic, cationic amphiphilic compounds. Amiodarone is a classic example. With long-term use, it deposits in the cornea and produces a swirling, vortex-like pattern visible on slit-lamp exam. Most people don’t have symptoms, though rare visual disturbances can occur, and the pattern tends to correlate with dose and duration. The changes can fade after stopping the drug or persist for a while. Digoxin causes color-vision changes (like xanthopsia) rather than corneal deposits; warfarin and clonidine are not typically associated with vortex keratopathy.