Whorl keratopathy is most characteristically caused by which medication?

• A. Amiodarone
• B. Timolol
• C. Prednisolone
• D. Chloroquine

Answer: (A)

Vortex keratopathy, or corneal verticillata, happens when certain drugs deposit in the corneal epithelium and form a whorl-like pattern as the epithelium turns over. Amiodarone is the classic cause because it is highly lipophilic and accumulates in corneal epithelial cells, creating lamellar, lipid-rich inclusions that line up in the distinctive whorl (vortex) pattern. This change is usually bilateral and often asymptomatic, though mild visual phenomena can occur and deposits may persist after stopping the drug. While chloroquine can also cause corneal verticatta, amiodarone is the most characteristic agent taught for this finding. Timolol and prednisolone do not typically produce this vortex keratopathy, with the former more linked to surface irritation and the latter to cataracts or glaucoma-related effects rather than corneal epithelial deposits.