A patient on amiodarone is diagnosed to have cornea verticillata. What should be management: (PGI Dec 2010)
High-Yield Explanation
Ans: A (Stop the drug) {Ref: Parson 20th/ 206 ; American Academy of Ophthalmologist: Cornea Section 8 2009-2010/375;Cornea by Krachner 2nd/365-69; Kanski 6th/321]Cornea Verticillata Parson 20th/206This is a whorl- like opacity in the corneal epithelium seen in patients on long-term treatment with medication such ad amiodarone, chloroquine, phenothiazines and indomethacin.It is also seen in patients with Fabry disease and its carrier state. The condition is generally asymptomatic, harmless and reversible on stopping the drugQ.The whorl-like pattern shows the direction of migration of corneal epithelial cells. Occasionally the condition had been known to cause glare and surface discomfort which responds to topical lubricantsPigment Deposition in Cornea Cornea by Krachner 2nd/365-6 9Superficial# Amiodarone QCh]oroquine' QChlorpromazineQIndomethacinClofazimineSuramineNaproxenTiloroneStromal# Phenothiazines"Corneal drug deposit: It is unusal for these deposits to result in reduction of visual acuity or ocular symptoms, although this has occurred in some patients. The development of deposits is not necessarily an indication to stop these medications, although the deposits will resolve with discontinuation of the responsible agents"- American Academy of Ophthalmologist: Cornea Section 8 2009-2010/375