All of the following drugs cause amorphous whorl like corneal deposits except:
Ans. d. Chlorpromazine (Ref: Goodman Gillman 12/e p1793; Khurana 5/e p69; Parsons 21/e p214)Amorphous whorl like corneal deposit suggests a case of vortex keratopathy. All the mentioned drugs cause this condition except chlorpromazine."The cornea, the conjunctiva, and even the eyelids can be affected by systemic medications. One of the most common drug deposits found in the cornea is from the cardiac medication amiodarone. It deposits in the inferior and central cornea in a whorl-like pattern termed cornea verticillata. It appears as fine tan or brown pigment in the epithelium. Fortunately, the deposits seldom affect vision, and therefore, this rarely is a cause to discontinue the medication. The deposits disappear slowly if the medication is stopped. Other medications, including indomethacin, atovaquone, chloroquine, and hydroxychloroquine, can cause a similar pattern. "--Goodman Gillman 12/e p1793"The phenothiazines. including chlorpromazine and thioridazine, can cause brown pigmentary deposits in the cornea, conjunctiva, and eyelids. The deposits generally are found in Descemet's membrane and the posterior cornea. They typically do not affect vision. The ocular deposits generally persist after discontinuation of the medication andean even worsen, perhaps because the medication deposits in the skin are slowly released and accumulate in the eye. "--Goodman Gillman 12/e p1793"Cornea verticillata: This is a whorl-like opacity in the corneal epithelium seen in patients on long-term treatment with medication such as 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 drug. The whorl-like pattern shows the direction of migration of corneal epithelial cells. Occasionally the condition has been known to cause glare and surface discomfort which responds to topical lubricants. "--Parsons life p214Systemic Agents with Ocular Side-effectsDrugsOcular Side-effects* AmiodaroneQ* IndomethacinQ* AtovaquoneQ* ChloroquineQ* HydroxychloroquineQ* Deposits in the inferior and central cornea in a whorl-like pattern termed cornea verticillataQ.* Appears as fine tan or brown pigment in the epithelium.* Deposits seldom affect vision* Deposits disappear slowly if the medication is stopped.* ChlorpromazineQ* ThioridazineQ* Brown pigmentary deposits in the cornea, conjunctiva, and eyelids The deposits generally are found in Descemet's membrane and the posterior cornea. They typically do not affect vision.* Ocular deposits generally persist after discontinuation of the medication and can even worsen, perhaps because the medication deposits in the skin are slowly released and accumulate in the eye.* Gold treatments for arthritisQ* Gold deposition in the cornea and conjunctiva, which are termed chrysiasis and are gold to violet in color.* These deposits usually disappear with discontinuation of the medication.* The deposits generally do not affect vision and are not a reason to stop gold therapy.* TetracyclinesQ* Yellow discoloration of the light-exposed conjunctivaQ.* Systemic minocyclineQ* Blue-gray scleral pigmentation that is most prominent in the interpalpebral zoneQ.
Chloroquine
Amiodarone
Indomethacin
Chlorpromazine
Adverse Drug Effect