Tamoxifen keratopathy as seen with in-vivo confocal microscopy.

Tamoxifen is a triphenylethylene non-steroidal oestrogen antagonist widely used in oestrogen receptor-positive breast cancer, with well-documented ocular side-effects. Here we report a corneal confocal microscopy finding of a patient on low-dose tamoxifen. We believe that this is the first case report of a patient on low-dose tamoxifen with demonstrable corneal stromal crystalline deposits with confocal microscopy, but clinically asymptomatic with unremarkable corneal findings on cursory slit lamp examination. In summary, confocal microscopy is a useful adjunct in monitoring tamoxifen crystalline keratopathy, and helps detect subclinical deposits not visible/detected on slit lamp examination.