Vortex Keratopathy

Abstract

Cornea verticillata, also known as vortex keratopathy, is characterised by a distinctive whorl-like pattern of epithelial deposits in the cornea. It is commonly associated with systemic medications such as amiodarone, hydroxychloroquine, and chloroquine, among others. These deposits are usually asymptomatic and reversible upon discontinuation of the causative drug. The pathogenesis involves lysosomal dysfunction triggered by cationic, amphiphilic drugs, leading to phospholipid accumulation in corneal epithelial cells. Although most cases are benign and do not affect visual acuity, rare instances of optic neuropathy and retinopathy have been reported, especially with prolonged amiodarone use. Management typically involves observation, with drug discontinuation reserved for symptomatic or vision-threatening cases. Emerging therapies such as topical heparin have shown promise in limited reports.