Identifying and treating amiodarone-induced corneal deposits: When the heart saves and the cornea speaks

Amiodarone remains a mainstay in the treatment of potentially life-threatening cardiac arrhythmias, yet its long-term use is well known to induce cornea verticillata, an epithelial alteration related to intracellular phospholipid accumulation. In most cases these deposits are clinically silent, but some patients may report glare, halos, blurred vision, or ocular discomfort, symptoms that can negatively affect visual quality and, in selected cases, influence treatment adherence, particularly in individuals with severe cardiovascular disease. This mini-review examines the current evidence on the pathophysiological basis, clinical manifestations, and diagnostic features of amiodarone-related corneal changes, with a focus on slit-lamp biomicroscopy and newer multimodal imaging approaches, including in vivo confocal microscopy. Management is considered within a multidisciplinary framework, where ophthalmic findings must be interpreted alongside the often-essential role of amiodarone in cardiac care. Special attention is given to ophthalmic follow-up, symptom-guided management, and patient counseling. By bringing together the perspectives of ophthalmology and cardiology, this review outlines practical strategies to maintain visual comfort without compromising the systemic benefits of antiarrhythmic therapy.