Systemic drugs affecting cornea

systemic drugs affect cornea
corneal toxicity

1. Drugs Affecting Cornea Vortex keratopathy / cornea verticillata : characterized by whorl-like corneal epithelial deposits.  1. Signs: • Bilateral, fine greyish or golden-brown opacities in the inferior corneal epithelium. Arborizing horizontal lines

2. Drugs Affecting Cornea Causes: a. Antimalarial Chloroquine ( Nivaquine , Avlocor ) Hydroxychloroquine ( Plaquenil ) INDICATIONS: malaria; certain rheumatological disorders Unlike retinopathy, keratopathy bears no relationship to dosage or duration of treatment. reversible on cessation of therapy.

3. Drugs Affecting Cornea b . Amiodarone INDICATIONS: atrial fibrillation; ventricular tachycardia • keratopathy - slowly reversible on discontinuation of medication. Higher dose/ longer duration of administration more advanced the corneal deposits. • keratopathy does not affect vision- discontinuation not indicated. Other toxic effects- anterior subcapsular lens deposits optic neuropathy

4. Drugs Affecting Cornea CHLORPROMAZINE: INDICATIONS- sedative; psychotic illnesses SIGNS- innocuous, subtle, diffuse yellowish-brown granular deposits in the endothelium, Descemet membrane and deep stroma occurring only in exposed cornea of the interpalpebral fissure anterior lens capsule deposits retinopathy Doses greater than 500 mg/day given for prolonged periods have a higher incidence of irreversible corneal and lenticular deposits.

5. Drugs Affecting Cornea ARGYROSIS: discoloration of ocular tissues secondary to silver deposits, and may be iatrogenic or from occupational exposure. Keratopathy is characterized by greyish brown granular deposits in Descemet membrane. The conjunctiva may also be affected.  

6. Drugs Affecting Cornea CHRYSIASIS: Deposition of gold in living tissue, occurring after prolonged administration. treatment of rheumatoid arthritis.    SIGNS: • Corneal chrysiasis : characterized by dust-like or glittering purple granules scattered throughout the epithelium and stroma , more concentrated in the deep layers and the periphery. total dose of gold compound >1500 mg develop corneal deposits. not an indication for cessation of therapy.   innocuous lens deposits marginal keratitis.

7. Drugs Affecting Cornea AMANTADINE: INDICATIONS: Parkinson disease. SIGNS: Diffuse white punctate opacities that may be associated with epithelial edema, 1–2 weeks after commencement of therapy (dose 200-400 mg/d). Resolve with discontinuation of treatment.