Which medication is commonly associated with vortex keratopathy (whorl keratopathy) in the cornea?

• A. Digoxin
• B. Amiodarone
• C. Chloroquine
• D. Hydroxychloroquine

Answer: (C)

Vortex keratopathy happens when certain systemic medications deposit in the corneal epithelium, producing a distinctive whorl-like pattern seen on slit-lamp exam. Chloroquine is a well-known culprit because its lipophilic, cationic amphiphilic nature drives deposition within epithelial cells, forming the classic corneal verticillata. These deposits are often asymptomatic, though some patients notice mild blurred vision or halos, especially in bright light. The pattern can appear weeks to months after starting therapy and may persist for some time after stopping the drug. While amiodarone and hydroxychloroquine can also cause similar corneal changes, chloroquine is a recognized cause among the choices, whereas digoxin is not typically associated with vortex keratopathy.