Plaquenil Eye Health Exam

Plaquenil, hydroxychloroquine (HCQ), is in a class of medications first used to prevent and treat malaria. Today, Plaquenil is a proven and widely used medication in the treatment of rheumatoid arthritis, lupus, other inflammatory conditions, and autoimmune diseases. When taking any systemic medication such as Plaquenil, there are possible risks and side effects related to the eyes. Although rare, Plaquenil usage can cause retinal toxicity that could lead to irreversible vision damage or vision loss.

Patients starting treatment with Plaquenil should have a baseline eye examination within the first year of taking this medication and then regular eye exams thereafter; every six months or yearly as recommended by our eye doctors. This exam involves several baseline measurements and assessments that can be compared over time to monitor any changes to your vision including refraction, visual acuity, dilated fundus exam, a visual field test, and an OCT (ocular coherence tomography), which is a photograph of the retina.

In early toxicity from Plaquenil, there are no visible signs to the patient but there are changes that can be detected by the visual field and OCT testing. Risk factors that may increase the likelihood of Plaquenil toxicity include age over 60, daily dose of more than 400 mg, use of Plaquenil for more than 5 years, obesity, pre-existing retinal disease, and renal or liver failure.